Obamacare Misses The Target

by William Teach | March 31, 2014 8:56 am

Over at the Boston Globe[1], John Sunuunu offers a scathing look at Obamacare, noting that it misses the target

The law clearly states that today is the final day to sign up for Obamacare. Only it isn’t. The extension announced last week[2] covers anyone who merely claims they intend to apply. Allowing such a frivolous and unverifiable gesture to circumvent the law neatly captures the paternalistic arrogance of the White House and its signature legislation – only the intent matters. Pay no attention to the cavalcade of undesirable consequences; if we mean well, we can do whatever we want.

The old proverb tells us that the road to hell is paved with such good intentions. But in the short term, the Obama team’s obfuscations have paid political dividends. For example, media attention has centered lately on the gross number of enrollments – the assumption being that if that number reaches 6 million, the latest White House target, then everyone can declare victory and move on.

But the overarching objective of the Affordable Care Act was never a specific enrollment target or, say, smoothly running software. The goal was to dramatically reduce the number of Americans without health insurance while reducing costs. On that score an honest look at the numbers reveals true failure. The vast majority of those signing up to date were previously covered, a travesty given the bill’s 10-year cost of over $2 trillion[3].

Begin with the administration’s claim of 5 million enrollments at mid-March, and generously assume they reach 6 million by the deadline. Unfortunately, not all will pay. Analysts at Goldman Sachs estimate that about 20 percent of those who sign up won’t follow through[4], leaving 4.8 million bona fide Obamacare exchange participants.

How many were uninsured last year? The White House doesn’t seem to know or care. A nationwide survey of those eligible by McKinsey Consulting[5] determined that between 11 and 27 percent were previously without coverage. Accepting the higher figure, the exchanges have taken 1.2 million off the rolls of the uninsured.

Mr. Sunuunu goes on to note the issues with the Medicaid numbers, the low young healthy enrollments, and then costs, which are, unsurprisingly, expected to dramatically increase.

Let’s further consider the stated goal, which was to make sure that the 30-45 million Americans without health insurance were able to gain health insurance. How’s that working out? Millions lost their insurance plans and had to re-enroll in what was typically higher cost plans with much higher deductibles and reduced networks.

(NY Times[6]) In a plain brown health clinic on a busy boulevard here, the growing pains of the Affordable Care Act are already being felt – almost too sharply for the harried staff trying to keep up with the flow of patients.

Tamekia Toure, 40, is typical of the clinic’s new patients, a single mother and recent arrival from Alabama with diabetes, high blood pressure, chronic pain and, for much of her adult life, no health insurance. For her, the new law is a godsend, providing Medicaid coverage that she would not have received before.

Then there is Donna Morse, 61, a widowed dental hygienist and yoga buff who is long overdue for a mammogram and blood work. She lost her insurance last year because it did not meet the new law’s standards. Now she has a new plan with much higher premiums, and which few doctors and hospitals will accept. So she too, warily, has landed at the clinic, one of seven here called Family Health Centers.

David Elson, 60, who has been coming to Family Health Centers for several years now, is a self-employed businessman with a multitude of health problems and medical bills. Despite chronic ailments, he went without insurance for years before enrolling in a subsidized private plan. He has not paid the first month’s premium, and could well fall back into the ranks of the uninsured.

The article essentially starts out with four stories. You get Ms. Toure, who was dumped into Medicaid, and is now on the public dole. Ms. Morse, who lost her insurance thanks to Obamacare, and now has a more expensive plan with a smaller network. And Mr. Elson, who hasn’t paid his premium. Then there’s the notion in paragraph one that quality of care will be reduced because those at medical facilities will be running around like chickens without heads. Or, they’ll just restrict their patient load, leaving many out in the cold searching for help. That’s one hell of a way to start an article that is, if you read further, attempting to defend Ocare.

A burdensome, costly law which wasn’t read by most, if not all, of those who voted in the affirmative. Few people without insurance signing up. Those same uninsured unable to afford to obtain insurance. Bald faced lies about keeping your doctor, keeping your plan, and reduced costs. Program costs skyrocketing, born by the taxpayer. And we haven’t even really gotten to rationing and bureaucratic control of procedures, as established by the Independent Payment Advisory Board, ie, “death panels[7]“. Back to Mr. Sunuunu

Liberals have long derided a more cautious “piecemeal” approach to reducing the number of uninsured: ensuring low-priced catastrophic coverage for the young; allowing insurance competition on a nationwide basis; and more aggressively targeting subsidies for those in need. They failed to recognize that covering the uninsured is difficult, complex, and – as Massachusetts has learned – expensive. The first goal should have been to do no harm to those parts of the system that were working.

Paternalistic coverage for those without insurance was never the point, and they really never cared about keeping you plan, etc: they simply wanted Government to be in control of 1/6th of the US economy and your health care, making people more likely to vote Democrat.

Crossed at Pirate’s Cove[8]. Follow me on Twitter @WilliamTeach[9].

Endnotes:
  1. Boston Globe: http://www.bostonglobe.com/opinion/2014/03/30/obamacare-misses-target/0mNpXnRGH4m5ERcSgkcQLO/story.html
  2. extension announced last week: http://www.politico.com/story/2014/03/obamacare-affordable-care-act-105036.html?hp=l10
  3. the bill’s 10-year cost of over $2 trillion: http://www.cbo.gov/publication/45159
  4. about 20 percent of those who sign up won’t follow through: http://www.forbes.com/sites/scottgottlieb/2014/03/11/how-many-people-did-obamacare-really-enroll/
  5. nationwide survey of those eligible by McKinsey Consulting: http://www.forbes.com/sites/theapothecary/2014/03/08/mckinsey-only-14-of-obamacare-exchange-sign-ups-are-previously-uninsured-enrollees/
  6. NY Times: http://www.nytimes.com/2014/03/31/us/in-new-health-care-era-blessings-and-hurdles.html?hpw&rref=us&_r=0
  7. death panels: http://prospect.org/article/death-panels-are-coming
  8. Pirate’s Cove: http://www.thepiratescove.us/
  9. @WilliamTeach: http://twitter.com/WilliamTeach

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