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Obamacare - what went right and what went wrong

Part 1 of a multi-article post.  This is looking back.  The next will look at alternatives for the future.

What went right

1. About 20 Million more people have coverage thanks to Obamacare

2. No more preexisting exclusions


What is debatable or uncertain

3. More young people have coverage on their parents policy

  • President Obama touted this during his re-election
  • The counter-argument is that proponents of the law were counting on young people buying individual coverage to offset the cost of older or sicker people entering the market.  How do you reconcile that goal with giving young people coverage for free under their parents' policy?  Is it any surprise that people are complaining now that rates are going up because not enough healthy people bought coverage?  And who are the healthiest people you know?  Those aged 18 to 26 who can now stay on their parents' coverage.

4. Obamacare will make people healthier - on this point the NY Times says "For those who believe the primary goal of the law was to make Americans healthier, the answer has to be: It is too soon to tell."

What failed

5. If you like your health plan you can keep your health plan - Politifact named this the "Lie of the Year"

6. If you like your doctor, you can keep your doctor - even the NY Times admits "Obamacare’s authors did not expect so-called narrow network plans to become so widespread. These have made it hard for some customers to find any plan that includes their favored providers..."


7. There will be more competition in the marketplace - Nope, not happening
  • ·         1/3rd of counties in the US will have one insurer in 2017 

  •   Alternatives to health insurers aren't working
    • Co-ops failed, these were non-profits set up with Govt. money to compete with insurers
    • Accountable Care Organizations are not succeeding - hospital/doctor based care organizations
  • Health insurers are merging - Anthem, Aetna, Cigna have been buying other insurers 

 8. Buying insurance on State exchanges - first States did not build them, second remember the disaster when the Federal exchange went online?      

9. Competition will keep prices down - Not working.  Premiums are rising at double digit rates.

10. Out of pocket costs will be reduced - Just the opposite they keep increasing

11. This will be good for the economy 
  • First, do you remember how employers started reducing people's hours to below 30 hours per week to not have to buy health insurance?
  • Second, before Obamacare health insurers did not outsource jobs.  That changed fast and thousands of Americans lost their jobs

12. This will be good for the deficit - 
  • This was predicated on insurance prices leveling or going down.  They have not, therefore Government spending on subsidies is higher than anticipated
  • The number of people on Medicaid, due to Medicaid expansion is higher than anticipated and that has increased Government spending

13. Young people will buy insurance - A key requirement to controlling rates, this has not happened and that's one reason rates are going up 


           


                    
Sources:

1. multiple articles cite the Urban Institute for that number
3. a source for the fact that rates are going up due to less healthy people signing up is: http://money.cnn.com/2016/10/25/news/economy/obamacare-problems/index.html?iid=EL
7. Multiple parts
           Second sub bullet: http://tinyurl.com/ladyxyy and http://tinyurl.com/kaefrwp
9. Sources for prices going up 
10. Sources for out of pocket costs increasing
11. Bullet 1 

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