The impact of ObamaCare on doctors and patients, companies inside and outside the health sector, and American workers and taxpayers

In its quest to remake the nation’s health care system, the Obama administration has urged doctors and hospitals to band together to improve care and cut costs, using a model devised by researchers at Dartmouth College.

But Dartmouth itself, facing mounting financial losses in the federal program, has dropped out, raising questions about the future of the new entities known as accountable care organizations, created under the Affordable Care Act.

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The best measurement of people who lack health insurance, the National Health Interview Survey published by the Centers for Disease Control and Prevention (CDC), has released early estimates of health insurance for all fifty states and the District of Columbia in the first quarter of 2016. There are three things to note.

First: 70.2 percent of residents, age 18 to through 64, had “private health insurance” (at the time of the interview) in the first quarter of this year, which is which is the same rate as persisted until 2006. Obamacare has not achieved a breakthrough in coverage. It has just restored us to where we were a decade ago. Further, the contribution of Obamacare’s exchanges to this is almost trivial, covering only four million people.

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Steve Banke employs 40 people at 3-Points, a small IT outsourcing company he founded almost 15 years ago. And he wants those workers and their families to have strong health insurance options.

Employees at the firm, based in Oak Brook, Ill., can choose between two types of Blue Cross and Blue Shield of Illinois plans: a PPO with a broader network of hospitals and doctors or a cheaper HMO network. Banke’s company covers a percentage of the premiums, and those costs have risen rapidly over the past several years, often more than 12% annually, he said.

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Average premium increases above 25%, roughly one-third of U.S. counties projected to lack any competition in the Affordable Care Act (ACA) exchanges next year, and enrollment less than half of initial expectations provide strong evidence that the law’s exchange program is failing. Moreover, the failure is occurring despite massive government subsidies, including nearly $15 billion of unlawful payments, for participating insurers. As bad news pours in and with a potentially very rough 2017 open enrollment period ahead, the Obama administration signaled on Friday that it may defy Congress and bail out insurers through the risk corridor program. Congress should take all steps at its disposal to prevent the administration from doing so.

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Senate Republicans have returned from a seven-week recess with a unified message they plan to repeat until November: Obamacare is imploding.

News of double-digit premium increases in 2017, insurers pulling out of the marketplace, failing co-ops, and low enrollment numbers have handed an opportunity to Senate Republicans who worried about losing the majority in the fall. They get to say, “I told you so,” after a six years of Obamacare messaging, and they get to tell voters that a GOP majority will fix these issues.

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Conservatives should acknowledge that the coverage expansion is real, it is large (though not as large as we were led to expect), and that while it is not necessarily going to make people much healthier, it is probably going to reduce financial hardship among at least some of the people who have gained coverage. That’s significant, though we can still argue about whether the benefit was worth the cost. (If Obamacare were being voted on today, I would still oppose it).

Liberals, however, should also acknowledge uncomfortable facts. The first is that most of the decrease in the uninsured population came in 2014 and 2015, and is now leveling off. Unless younger and healthier people start buying insurance in much larger numbers, we’re probably not going to see huge improvement. The fact that so few young, healthy people are buying insurance may not only mean that the number of uninsured people stops going down. It could mean that that figure starts going up again.

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Six Republican Senators introduced a bill that would exempt consumers living in counties where zero or one insurer is offering plans on the federal exchanges from the Affordable Care Act’s individual mandate.

The legislation comes after several recent analyses have shown the number of U.S. counties with one insurer offering plans on the Affordable Care Act exchange is expected to increase next year. Pinal County in Arizona currently has no insurers planning to offer plans on the marketplace. Under the 2010 health care law, people who are able to afford health insurance are required to purchase insurance or pay a fine to the federal government.

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No wonder Politifact awarded President Barack Obama its 2013 “Lie of the Year” award for his Obamacare promise, “If you like your health plan, you can keep it.” My wife has been trying to do exactly that for three years, and has failed every time. But at least she was able to keep her doctor—until now.

I have previously discussed my wife’s struggles to find and keep coverage in the age of Obamacare. It was never a problem before Obama and Democrats decided the government needed to improve access to coverage.

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“You bet I voted for that bill. I’m proud I did it!” yelled Russ Feingold at a Wisconsin campaign stop in 2010. That pride—in ObamaCare—lost the three-term Democratic senator his job. Now his party’s ownership of the health-care law may once again decide the Senate.

ObamaCare is roaring back as a political liability to Democrats in a way not seen since that 2010 wave election. Right in time for this fall’s presidential contest, insurers are bailing out of the government system, leaving millions of voters with dwindling options and skyrocketing premiums. ObamaCare was always destined to crack up, but there is something notable that it comes precisely as so much control of Washington is up for grabs.

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Progress in reducing the number of people without health insurance in the U.S. appears to be losing momentum this year even as rising premiums and dwindling choice are reviving the political blame game over President Barack Obama’s health care law.

The future of the Affordable Care Act hinges on the outcome of the presidential election, and it’s shaping up as a moment of truth for Republicans.

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