No one can argue that Obamacare succeeded in getting more people insured. The debate is how successful it has been in controlling cost. Despite the ACA, health care cost have continued to rise* and now with such few providers willing to be on the exchange the insurance premiums are going to rise 25% and in some rural areas (the area that the health insurers don’t want to cover) the premiums will go up almost 40%. So taking into account EVERYTHING: insurance premiums and out of pocket costs, has Obamacare been a complete failure at lowering cost for the consumer.
*Over time, the claim that ACA would reduce health care cost has morphed into reducing health care cost growth.
The ACA’s concept was always flawed to begin with. The goal shouldn’t be to get more people insured; the goal should be to drastically reduce healthcare cost to begin with.
Suppose that everything at Walmart costs absurdly high prices (and Walmart is the only store in town) - a jar of peanut butter is $200, a gallon of milk is $300, a loaf of bread is $150, etc. And then someone says, “Let’s get everyone coupons so that they can get discounts on these products.”
The focus should have been on bringing down the cost of the products down to something reasonable, like $5 for peanut butter, $3 for bread, etc.
I’m curious. Could you define “controlling costs” for us. Does it mean “reduced costs the year after its adoption compared to the year before”? Does it mean “health care costs will permanently be lower than they were before ACA, forever and ever”? Does it mean “health care costs will be lower in the future than they would be without the enactment of the ACA”?
Just trying to figure out what measure definition of ‘controlling costs’ you think is reasonable to judge any kind of health care policy, ACA or otherwise.
(My personal opinion is and was that the ACA wasn’t actually going to address the primary reasons that health care costs are so expensive, so it certainly wasn’t going to solve that problem. But it did provide thousands of people with some kind of health care, which is definitely a good thing, even though it brought them into a broken and failing system. I also think that with the amazingly obstructionist congress at the time, nothing stronger or more revolutionary than the ACA was going to get through, and the opposition party had no solution that was better.)
ETA: Ditto what Velocity said. But again, the opposition party was so intent on keeping government “out” of health care, that constructive change was all but impossible.
In my opinion, many people who oppose ACA seem to think ‘controlling costs’ means ‘After adding tens of millions of people to insurance rolls, the healthcare expenditures will be reduced.’
Tangentially, I saw this post today, on this very subject, from a guy I used to work with:
According to CNN, 85% of those buying insurance on the exchanges receive subsidies. So, their costs wouldn’t actually be going up that much, if at all. The government would be spending more.
Now the 15% who don’t receive subsidies (I’m thinking some of those may live in states that don’t have Medicare expansion) will feel the full brunt of the costs.
[QUOTE=Johnny L.A. coworker]
In response to this, my comment was: "Yes to single-payer, or at least a public option, but in the meantime, Obamacare could have worked much better…if the GOP legislative majority hadn’t insisted on watering it down and seriously diminishing the originally intended effectiveness of the system…and then blaming the system’s deficiencies on Obama!
[/QUOTE]
Obamacare passed only because the Democrats had a filibuster-proof Senate and controlled the House.
There was a comment on CSPAN radio this morning that Congress has not passed/approved/appropriated several billion in payments to insurance companies. I was driving and might have missed something. Any insight.
Uhm - The Democratic party controlled the House and Senate for the first two years of Obama’s first term - there was not a GOP majority, or the ACA would have never been passed.
For this consumer, it certainly appears to be. I pay significantly more money for significantly worse coverage than I had before. I liked my plan before, but ObamaCare didn’t let me keep it.
That was during Obama’s second term, when there was a GOP majority. The ACA passed in 2010, when the Dems were still in control of Congress. If I’m not mistaken, I believe that the involvement of the ACA with the 2013 shutdown related to the future funding of the already-existing Act, not to its original passage.
ObamaCare passed in 2010. The 2013 debate about whether Congress was going to fund it or not did (AFAIK) nothing to change the law that was passed in 2010.
Only 25%? My daughter’s health plan is going up by 60%, with an increased deductible. She is legally obligated to buy health care, and she doesn’t qualify for any subsidies.
Perhaps what the architect of the plan promisedwould be a good starting point to evaluate it.
Unless it is cancelled.
Unless by “lowered” you mean “increased”.
Apart from the individual mandate tax, the medical device tax, and various penalties on HSAs.
Every single one, except for 31 million Americans.
Where “more” means “less” and “lower” means “higher”.
No, I can argue that since it’s a fact. Twenty million previously uninsured people have gained health coverage since the Affordable Care Act became law in 2010, per President Barack Obama .
Perhaps you meant “No one can argue that Obamacare didn’t succeed in getting more people insured.” ??
This is true. Basically, in setting up the ACA, there were supposed to be payments to Health Insurance companies, i.e., Payers, to offset the losses anticipated by having newly-insured folks who were likely to incur a lot of costs initially. Those payments were not funded, to my knowledge, by the GOP-led Congress, which is a key reason that some Payers are pulling out of the Obamacare exchanges and why rates are increasing to this degree.
I believe that Hillary has stated that in supporting the ACA, she would look to push those subsidies through.
Presumptive Democratic presidential nominee Hillary Clinton on Saturday announced a proposal to expand mandatory healthcare funding by $40 billion over the next 10 years, highlighting the influence that rival Democrat Bernie Sanders has had on her campaign.
“Clinton will also affirm her commitment to give Americans in every state the choice of a public-option insurance plan,” the campaign said in a statement, as well as allow individuals below Medicare age to opt in to the program. (Reporting by Alana Wise; Editing by Leslie Adler)
[/QUOTE]
This is what I was referring to: getting the states that chose not to fund a Medicaid co-co option, and providing subsidies to health insurance companies to offset their initial costs of taking on such costly populations.
Bottom line is that the ACA/Obamacare as we know it now is a structural compromise that has been underfunded through congressional action. So it is not surprising that it is not ramping up in a perfect way. If Hillary is elected and can address some of the biggest issues, it will be positioned to perform better.
Um, no. If you can cut the cost of a heart/lung transplant by 300%, you’re a genius, but that would still bankrupt most families. The ‘affordable’ part of the ‘affordable care act’ is accomplished by lowering the cost of insurance, which is accomplished by spreading risk over the largest possible pool of consumers. You can argue whether ACA is accomplishing that, but cost reduction was never the primary goal.
Cost reduction was never the primary goal? Come on! It at least was a primary goal.
ACA came into being because too many Americans couldn’t afford health care; either they didn’t have insurance, or the insurance they had was too expensive (and didn’t keep people out of the poor house when they had to rely on it). Health care reform had support from a large portion of the public because the public felt like it was spending millions (billions?) of dollars and not getting fair and reasonable ROI for that money.
The conversation about health care reform begins and ends with affordability; I don’t know how you can assert that, well, we covered more people, and that’s all that really mattered to anyone anyway.
And as far as your point about a heart transplant still being unaffordable even if we cut the expense 300% . . . well, then maybe not everybody gets a heart transplant. Not to turn this into a ‘death panel’ discussion, but there are some treatments/procedures that are not reasonable to expect to be able to get under our current model. It sucks, but I don’t think that pointing to expensive procedures and claiming that they’ll always be expensive makes any point other than the fact that there is a line somewhere beyond which certain medical treatments are luxury items.
I don’t know if I want to pay into a system that provides heart transplants for everyone. Maybe I do, if we can do it in an affordable manner. But this is the kind of question that ought to be behind honest efforts to reign in expenses. Is it sustainable to provide coverage of (and thus inflate the cost of) every expensive life-saving procedure? I mean, making up numbers that are wildly unrealistic here, but if having heart transplants available costs each American $50 a year on their premium, and they have to hit their deductible before they see any coverage, then maybe heart transplants are not things we as a society can afford. Or maybe they are, but only for people within a certain age range. Or maybe something else, but let’s talk about it. If we don’t start making real choices about what we’re willing to pay for and how much, we will remain in an endless cycle of increasing costs, and an adversarial and untrusting relationship between each and every American citizen and the health insurance industry.