Obamacare: Unaffordable and Incomprehensible

Chaos. “The whole mess has thrown the country, millions of people, the insurance market, into chaos,” wrote Paul Palumbo, one of the million Californians who were notified that because of the Affordable Care Act, their Blue Shield plans would end Dec. 31.

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When the self-employed research analyst received the notice, he stopped paying his premiums because “they were dropping” him. The cheapest alternative he could find costs 61 percent more than his old premium and has a higher deductible. For now, he’s waiting for the market to settle and rolling the dice. After President Barack Obama announced Thursday that he would allow insurers to sell 2013 plans for another year, Palumbo observed that it changes nothing. This new fiat “will only further confuse people and negatively impact the market’s ability to function efficiently.”

Is what Obama proposes even legal? When Republicans tried to delay the scheme, the administration responded that Obamacare is “the law of the land,” passed by Congress, signed by the president and upheld by the Supreme Court.

Covered California requires its providers to terminate old individual policies Dec. 31.

Insurers are not on board. They have tied their offerings into knots to meet the ACA’s voluminous regulations and calculated rates that anticipated current policyholders joining new pools. Now the president says to health care purveyors: Never mind. Do me a favor and sell your old plans with added bells and whistles — and for what you charged because you could exclude those with pre-existing conditions.

With this gambit, Obama essentially is trying to convince an estimated 5 million terminated policyholders across the country: If you lose your plan, blame the insurance companies.

The news conference followed a botched rollout capped by the release of anemic enrollment numbers. The administration had expected 500,000 people to sign up during October. Instead, 106,000 Americans enrolled. The numbers for California are better. Nearly 31,000 Californians signed up in October; another 24,000 enrolled in the first two weeks of November. According to Covered California Executive Director Peter Lee, older Californians are overrepresented and younger Californians are underrepresented in the applicant pool.

If too few healthy and young people participate, warned Devon Herrick, senior fellow of the National Center for Policy Analysis, the result will be an “adverse selection death spiral.”

Anthony Wright of Health Access rejects any suggestion that a million Californians are losing their coverage so that a hoped-for 500,000 to 700,000 can get subsidized plans. “There’s already more than a million people who are getting coverage,” he said, when you add the 435,000 adults younger than 26 enrolled on their parents’ plans and the 615,000 newly enrolled in Medi-Cal and similar programs.

For those Californians, the Affordable Care Act actually is affordable. For those who pay for their health care, probably not.

“The old individual market was not working well,” Obama said in his defense. If so, the new individual market is working worse. It turns out that when the government adds benefits and makes insurers charge the same for people with pre-existing conditions, costs go up. Individual policyholders who do not qualify for subsidies are experiencing severe rate shock — and they’re losing their doctors.

This is where liberals like to insert that Republicans never wanted Obamacare to work. Not quite. Republicans always knew that Obamacare could not work.

Email Debra J. Saunders at: dsaunders@sfchronicle.com.: 

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