It’s been almost six years since President Barack Obama signed the Affordable Care Act into law, and it’s become clear that it has failed to achieve any of it’s major objectives. Moreover, there is increasing evidence that the law will never do what it was intended to do. So at what point can we admit that Obamacare is a failure and move on to real health care reforms?
How do we know that it’s failed? Unfortunately, the Affordable Care Act is an incredibly complicated piece of legislation, and there is nowhere near enough space in this article to dig through the entire thing piece by piece. It was so complicated, after all, that a certain Speaker of the House notoriously stated, “we have to pass the bill so that you can find out what is in it.” We can, however, look at the overarching goals of the legislation, which I summarize as the following; to lower health care costs, to force states to provide health insurance to low-income Americans through Medicaid, and to help Americans afford private health insurance through the Exchanges.
Obamacare stumbled right out of the gate. While the Supreme Court refused to strike down the whole law, they struck down the mandatory Medicaid expansion, making it optional for states. While the promise of 90% federal funding for the expansion was enough to entice some states to opt in, several have stood fast against the future budget-busting expansion. Among states that opted in, enrollment blew past projections, increasing the program’s pressure on state budgets. As federal funding drops over the next several years, the cost of Medicaid expansion for states will only rise.
Still, the relevant point here is that Obamacare was meant to provide insurance to all Americans under 138% of the poverty line with health care through the Medicaid program, and it has failed to do so. And as states are forced to bear more of the costs, expect them to put pressure on Washington to allow them to reduce Medicaid eligibility. While progressives will claim victories for the millions reached by Medicaid expansion, they have to admit that expansion has fallen far short of Obamacare’s goals.
A second goal of Obamacare was to lower health care costs. In 2009, the president stated, “We agree on reforms that will finally reduce the costs of health care. Families will save on their premiums; businesses that will see their costs rise if we do nothing will save money now and in the future […] whatever ideas exist in terms of bending the cost curve and starting to reduce costs for families, businesses, and government, those elements are in this bill.”
Well, in the years since the law passed, premiums have risen and health care costs have actually grown. While progressives will claim that the growth of health care costs have slowed down due to Obamacare, the slower growth is more attributable to the economic recession than the president’s health care overhaul. In fact, health care costs are expected to grow much more rapidly over the next few years as the economy improves. Again, Obamacare has failed to achieve one if its major goals, reducing health care costs. That’s two down–but surely Obamacare achieved it’s third goal of enrolling millions of Americans in health insurance through the exchanges.
True, millions of Americans have enrolled through the exchanges. What’s important to note however, is that when Congress passed the law, they did so with the expectation that it would eventually enroll 24 million Americans. This year, the White House has announced that it only expects around 11 million enrollees. That is a massive gap between expectations and reality, and an updated CBO estimate claims that enrollment will peak at only 16 million enrollees! That’s not chump change, but it’s far from what legislators expected when they voted on the bill. Would Congress have passed the bill if they knew that enrollment would be 30% lower than the CBO’s original projection?
Any other program that fell that far short of expectations would be declared an outright failure, yet liberals go into cheerleader mode every time enrollment passes the White House’s drastically lowered estimates. Despite the spin, it’s clear that Obamacare has failed in it’s efforts to enroll Americans through the exchanges.
On all three counts, Obamacare has failed to achieve its goals, so when can we all admit that it’s a failure? It’s time to wipe the slate clean and start again. If progressives really want to make health care affordable for all Americans, then we need to stop putting so many resources into a law that is clearly not doing what it was designed to do.