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

Donald Trump’s healthcare plan is a “whipsaw of ideas” and an “incoherent mishmash that could jeopardize coverage for millions of newly insured people,” according to conservative health policy experts. Mr. Trump’s health care platform “resembles the efforts of a foreign student trying to learn health policy as a second language,” according to AEI’s Tom Miller. AEI’s Jim Capretta adds that replacing the ACA would require a “herculean effort, with clear direction and a clear vision of what would come next. I just don’t see that in Trump’s vague plans to repeal the law and replace it with something beautiful and great.” Trump must “discard some of his ideas, like the importation of prescription drugs, because they would be damaging and unworkable,” according to Grace-Marie Turner. “And he has to flesh out his other proposals with much more detail if he hopes to persuade voters that he has a credible plan to replace Obamacare.” Robert Laszewski, a former insurance executive, called Mr. Trump’s health care proposals “a jumbled hodgepodge of old Republican ideas, randomly selected, that don’t fit together.”

Health jobs grew more than two thirds faster than non-health jobs in March, they comprised 37,000 (17 percent) of nonfarm civilian jobs added (215,000).

There is significant increase in health services jobs under Obamacare. It is unlikely we will bend the curve of health spending as long as we keep adding relatively unproductive health services jobs.

The Affordable Care Act’s tax increases are many, two are front and center this month: the individual and employer mandates. They were both supposed to increase coverage, but in reality they’re limiting career opportunities and taking more out of families’ and individuals’ wallets.

After six years of Obamacare and three years of the exchanges Americans have learned a few lessons. The healthcare.gov disaster was due to the complexity of the website, an awful procurement system, and lack of adequate management by the administrationg. Establishing an insurance company is more than just paying claims, as you can see with the failure of half of the co-op insurers around the country. Finally, people don’t want to spend a lot of money on insurance.

The Association of Medical Colleges released a report that says America will be short a million doctors by 2025 and that the shortage of primary care physicians makes up a third of that number. There are several reasons for the shortage of primary care physicians including “fee for service” payment model and the mandate for doctors to switch to electronic health records (EHR), which is a time consuming, costly addition to physician’s duties.

Obamacare created a system that actually made insurance more expensive, decreasing access to the poor and sick, while pricing out average Americans from affordable health care coverage. Millions more have been added to Medicaid, millions have seen double or triple their annual premiums and millions have opted not to be insured at all.

Only the top five insurers have profits in excess of $1 billion. All the others had 2014 profits of less than $300 million. But the top five also have membership of at least 20 million, with Humana being the lowest (21.4 million) and CIGNA and UnitedHealthGroup having the highest (86 and 85 million members worldwide, respectively).

When you divide a figure measured in billions by membership measured in many millions, the resultant is rather modest. The average Fortune 500 health insurer earned profits of only $51 per member in 2014. Thus we could trim the monthly health insurance premium by about $4.25 were we to confiscate all those “obscene profits” and give them back to plan members.

In the March 8 rule, the Department of Health and Human Services (HHS) stated that Health Savings Account (HSA) eligibility was not a meaningful distinction for health plans because consumers can determine whether a plan is HSA-qualified by examining a plan’s cost-sharing amounts. Therefore, it will not require HSA-qualified plans to be designated as such.

Two main reasons why HSA-qualified plans will not survive is because plans must cover services below the deductible that are not considered “preventative care.” And the plans must apply specific deductibles and out-of-pocket limits that are outside the requirements for HSA-qualified plans.

Highmark Health lost $590 million in its health plans that were sold on the ACA exchange in 2015. Highmark is still owed $500 million under the risk-corridor program, and HHS has said it will find a way to fund the program. Highmark Health CEO, David Holmberg said Highmark has met with government officials “regularly to discuss how they plan to honor their commitment.”

Obama promised that Obamacare would “save all of us money and reduce pressures on emergency rooms all across the country.” However, a new report by the Centers for Disease Control and Prevention shows, that by doling out insurance coverage to millions more people without doing anything to address America’s growing doctor shortage, the president’s health reform law may make the ER crisis even worse.