Monday, December 30, 2013

Top Six Broken Obamacare Promises

The Affordable Care Act (ACA), better known as Obamacare, is the biggest health care overhaul this country will have experienced since Medicare and Medicaid. Especially with the dismal launch of Healthcare.gov, Obamacare has rightfully come under a good amount of criticism and ridicule. To show just how much of a debacle Obamacare has been thus far, here is my compiled list of the top six broken Obamacare promises:
  1. "If you like it [your current health care plan], you can keep it. Nobody is forcing you to switch." This utterance of President Obama is so infamous that Politifact.com deemed it the "Lie of the Year." The federal government's midrange estimate was that more than half of employer-based insurance would be cancelled (Federal Register, June 2010, p. 34452-34453) due to the new law. Even the White House Press Secretary conceded that "only" 5 percent would probably lose insurance (which, for those doing the math, is about 15 million). We are already seeing these predictions come true. Obamacare has already caused the cancellation of five million individual plans, mine included. It is expected to affect 7-12 million Americans with individual insurance plans. HealthPocket, a healthcare consulting firm, points out that only two percent of individual health care plans qualify under ACA requirements. According to the Congressional Budget Office (CBO), seven million Americans will lose their employer-based insurance once the law goes into effect. 
  2. "In an Obama administration, we'll lower premiums by $2,500 per family." Obama promised savings that would translate into lower premiums for those who buy insurance through Obamacare. This claim applies to some, but not others. Lowering the premiums of some comes at the price of raising the premiums of others. If you had a pre-existing condition, odds are you're paying less. For a young healthy individual, they're most likely paying more. Those with employer-based insurance should also expect to pay moreHeritage Foundation found overall premium increases in most states. Even if the premiums are slightly lower "than expected," does it do much good if deductibles substantially increase
  3. "I absolutely reject that notion [that Obamacare is a tax]." Americans are not too keen about tax increases. A lack of tax increases was one of the primary promises Obama made in order for the bill to get passed. Let's start off with the fact that the Supreme Court ruled that the individual mandate in the ACA is indeed a tax. The revenue side is being handled by the Internal Revenue Service (IRS), the organization that is responsible for tax collection and tax law enforcement. Aside from the tax on the individual mandate, there is the employer "mandate" that requires employers with fifty or more employees to provide health insurance, as well as a plethora of tax hikes courtesy of Obamacare
  4. "I will not sign a plan that adds one dime to our deficits, either now or in the future." Yet another promise President Obama could not keep. A Government Accountability Office report (p. 19) shows that Obamacare increases the deficit by about $1T over the next decade. The Congressional Budget Office (CBO, Table 2) puts it at about $1.3T for the next decade, which is a higher amount than Obama promised. Obamacare provides coverage to more people. Furthermore, it covers more treatments, such as preventative care, maternity and newborn care, chronic-disease management, and many other types of treatments. With more coverage for more individuals, how can one intuitively expect costs to decrease? But let's look at numbers. Proponents like to argue that Obamacare has been responsible for lowered healthcare costs over the past few years. Aside from the fact that the law is not fully in effect, there is the issue that the single largest factor in the decrease for healthcare costs in the past five years is the Great Recession. What about moving forward? The CBO shows that health care costs as a percentage of GDP will increase. The Center for Medicare and Medicaid Services shows similar upward trends (Table 1), whether in terms of percentage of GDP, nominal dollars, per-capita spending, or inflation-adjusted dollars. 
  5. "I will sign a universal health care bill into law." Obama promised coverage for every American, but Obamacare will not deliver on this promise. According to the Congressional Budget Office (Table 1), there will still be 31 million uninsured Americans in 2023.
  6. "That means that no matter how we reform health care, we will keep this promise to the American people: If you like your doctor, you will be able to keep your doctor, period." This promise is tenuous at best. What Obama should have said is "if you like your doctor, you can keep your doctor if you can afford to do so." Both CNN and the New York Times already realize that any of Obamacare's "cheaper costs" (See Points #2 and #4) come at the cost of a more constricted network of providers. Let's combine that with the fact that if you cannot keep your plan (See Point #1), which decreases the probability that you will be able to keep your doctor. Furthermore, let's go to what Left-leaning Ezra Klein calls the "healthcare trilemma." This trilemma exists between accessibility, comprehensiveness, and affordability. According to Klein, Obamacare provides more comprehensive and accessible health care. The problem is that comprehensiveness and accessibility come at the expense of affordability. Wasn't the premise of the Affordable Care Act that healthcare could be more affordable? What good is it to have comprehensive and accessible healthcare in which you "keep your doctor" if the deductibles are so high that you cannot afford to pay the bill? If this has taught us anything, it's that the Affordable Care Act is nothing more than a misnomer that will adversely affect the healthcare of millions of Americans.

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