Obamacare: No Successes to Build On

Obamacare: No Successes to Build On

Presidential candidate Hillary Clinton has vowed to “defend and build on the successes of Obamacare.” What are these imputed successes? Are they real, or is this just her magical thinking? What does the evidence show?

Obamacare has produced an increase in the number of Americans who have health insurance. A reasonable estimate suggests 8.8 million individuals (2.9 percent of the population) gained health insurance between 2013 and 2014, the year that Obamacare was implemented. The vast majority — some say as many as 97 percent — did so through Medicaid expansion.

But before we shout “Hurrah!” for Obamacare, let’s examine some of its other effects. The first is cost. Someone has to pay for the “free” coverage that Medicaid expansion provides. The price tag to insure those 8.8 million people? $296,454 each — the cost of Obamacare at $2.6 trillion divided by 8.8 million newly insured.

Moreover, the benefit of insuring more people at no charge to them is offset by a concomitant decrease in access to care. To pay for these expanded Medicaid programs, reimbursements to doctors had to be cut. This, in turn, has reduced the availability of providers. 

Back in 2009, Robert Moffitt of the Heritage Foundation testified before Congress, “You can’t get more of something [such as health care] by paying less for it.” Experience has proved the wisdom of his warning. More insured people with fewer doctors to care for them is hardly a “success.” 

Most have forgotten that president Obama stated that his primary reason for reforming the U.S. healthcare system was to “bend down the spending curve,” only secondarily to insure everyone or to make health care affordable. In other words, we were overspending nationally, and we couldn’t afford to keep it up. 

No one — not President Obama, Nancy Pelosi, or Hillary Clinton — can claim that Obamacare’s price tag of $2.6 trillion in new spending has “succeeded” in reducing national spending.

Since the nation doesn't have the $2.6 trillion necessary to pay for Obamacare, these costs must be added to the national debt. Spending that money today and forcing our children to pay it back tomorrow is not anyone’s definition of success. 

The official name for Obamacare, of course, is the Affordable Care Act (ACA). Has it succeeded in making care affordable?

As President Obama admitted after signing the ACA into law, the aim of the health-care reform is really to provide affordable insurance, not care. Has it delivered on that score? Did we get affordable insurance? 

Since the ACA took effect, the cost of insurance has gone up dramatically just about everywhere. Our previously unaffordable health insurance is now even less affordable. Before implementation of the ACA, analysts were warning us about “sticker shock.” Their predictions have been confirmed. Premiums are higher; co-pays and deductibles are up. Where is our promised affordable insurance? 

Under Obamacare, insurance companies cannot afford to sell insurance because their costs have gone through the roof. UnitedHealth reported losses in excess of $500 million in one year, while Aetna lost $430 million. No for-profit organization can keep that up for long. So both have stopped selling Obamacare insurance. What that means is that even as insurance costs go up, options to purchase go down. Would you call that success?

In sum, President Obama has saddled us with:

- More insured people, but diminished access to care.

- More spending, not less.

- No affordable health care.

- Less affordable health insurance. 

There are no Obamacare successes on which anyone can “build.”

Dr. Deane Waldman, MD MBA is the Director of the Center for Health Care Policy at the Texas Public Policy Foundation.

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