The further to the left or the right you move, the more your lens on life distorts.

Tuesday, October 27, 2015

Obamacare—Revisited

Those of us who opposed Obamacare from the beginning (I was one) had four major objections as the Affordable Care Act (ACA) was rammed through a Democratic congress without a single GOP vote.
  1. Legislation that affects virtually every citizen (either directly or indirectly) and that will influence almost 17 percent of our economy should be developed with bipartisan consensus, not arm twisting, shady deals, and outright lies to get the legislation passed.
  2. Promises of government "savings" were laughable, given the structure of the law and the ridiculous assumptions that were made. Today, government itself acknowledges that the ACA is expected to cost the taxpayers hundreds of billions of dollars over the next decade.
  3. Better coverage and lower premiums were promised, but the promises were not realistic. Exactly the opposite has happened. High deductibles and unaffordable premiums are the norm.
  4. "Everyone" would have medical insurance was the goal, but it was not a goal that was achievable under this law. It turns out that tens of millions still do not have policies. Even worse, the young, who were expected to participate in record numbers, have decided to take a pass.
All of this, coupled with a laughably incompetent roll-out of the program, continuing fraud and abuse allowing coverage of non-citizens and those ineligible for subsidies, growing medicaid rolls increasing taxpayer costs to exorbitant levels, and the lawless tendency to postpone and/or modify those elements of the ACA that might hurt the Dems politically, make the entire program a mess.

The Wall Street Journal delivered the bad news that Obama's trained hamsters in the media willfully avoid reporting:
Recruitment for 2015 is roughly 70% of the original projection, but ObamaCare will be running at less than half its goal in 2016. HHS believes some 19 million Americans earn too much for Medicaid but qualify for ObamaCare subsidies and haven’t signed up. Some 8.5 million of that 19 million purchase off-exchange private coverage with their own money, while the other 10.5 million are still uninsured. In other words, for every person who’s allowed to join and has, two people haven’t.

Among this population of the uninsured, HHS reports that half are between the ages of 18 and 34 and nearly two-thirds are in excellent or very good health. The exchanges won’t survive actuarially unless they attract this prime demographic: ObamaCare’s individual mandate penalty and social-justice redistribution are supposed to force these low-cost consumers to buy overpriced policies to cross-subsidize everybody else. No wonder HHS Secretary Sylvia Mathews Burwell said meeting even the downgraded target is “probably pretty challenging.”

The HHS survey shows three of four ObamaCare-eligible uninsured people think having coverage is important—but four of five say they couldn’t fit their share of the premiums into their budgets even after the subsidies. They’re not poor; they tend to have jobs in industries like construction, retail and hospitality but feel insecure financially; and they prioritize items like paying down debt, car repairs or saving to buy a home over insurance.

The law’s failure to appeal to the young and rising middle class is already cascading through the insurance markets. Researchers at the Robert Wood Johnson Foundation and Urban Institute recently published a remarkable study of the industry barometer called medical loss ratios, or MLRs, and the pressure is building fast.
This is still another of many examples of the fantasy world of the Obama administration colliding with a harsh reality.

It's likely that the ACA will collapse under its own weight, but as it collapses, the medical insurance industry will be wrecked, medical care will suffer, the drain on the treasury will be unacceptable, and the people who need catastrophic medical coverage will go without.

The ACA never should have been voted into being. It combines bad policy, inexplicably bad implementation and political posturing into a toxic brew. It is failing badly. It needs to be significantly reformed in a bipartisan manner, or better yet, replaced.

Too bad we have an administration that thinks it never makes a mistake and is more interested in protecting this president's legacy than it is in helping improve medical coverage. Obamacare is an epic fail. Too bad Barack Obama refuses to accept that sad truth.