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

On Wednesday, Kentucky Governor Matt Bevin announced that he was planning to keep ObamaCare’s Medicaid expansion, but would seek federal waivers to “transform” the program. But Bevin’s plan is already hitting an a snag: he wants to use a Section 1332 waiver to “transform Medicaid.” The snag: Section 1332 doesn’t provide any authority for Medicaid reform.

A group of state insurance commissioners is developing a proposal to limit the amount that health insurers might have to pay out under the Affordable Care Act’s risk adjustment program, New Mexico Insurance Superintendent John Franchini told SNL.

The plan would install a so-called circuit breaker to prevent companies from paying more than 2% of their premium revenue into the program each year. That boundary would make insurers’ financial obligations more predictable and avoid the kinds of surprise payouts that contributed to the destabilization of several health plans in 2015.

Only 7% of the uninsured correctly identify this as the deadline to enroll in coverage and 20% say they have been contacted by someone about signing up for coverage. When asked why they have not purchased health insurance this year, nearly half of the uninsured (46%) say they have tried to get coverage but that it was too expensive.

According to the Organization for Economic Cooperation and Development (OECD), the United States spends $8,713 per person on health care — more than double the OECD average.  But under ObamaCare, that high level of spending isn’t buying the best care. The law’s numerous regulations and intrusions have simply inflated the nation’s healthcare tab — without actually improving the quality of care available to patients. The US has long spent more than other nations on care. ObamaCare has just accelerated that trend, despite the law’s goal of reducing health spending. Last year, health expenditures jumped 5.3%, up from an average of 3.9% over the previous six years, according to data from the Centers for Medicare and Medicaid Services.

The Obama administration created a “risk corridor” program to help prop up insurers who lost money in the first three years of ObamaCare where profitable insurers would pay some of those profits into a pool to help insurers who lost money. If the amount insurers lost exceeded what the companies paid in, the government would step in and make up the difference. Calling this “a taxpayer-funded bailout for insurance companies,” Rubio last year quietly inserted language into the omnibus government spending bill that barred the Department of Health and Human Services from dipping into general funds to pay failing insurers. “While the Obama administration can still administer the risk-corridor program, for one year at least, they won’t be able to use taxpayer funds to bail out insurance companies,” Rubio said.

With the Affordable Care Act crumbling, progressive activists are all but guaranteed to grab the opportunity that this single-payer ballot measure represents. But if Coloradans truly want better health care at a lower cost for more people, they shouldn’t vote for another one-size-fits-all government program. They should vote for proposals—and politicians—that will give patients more choices.

Jeff Anderson argues that ObamaCare has an incurable preexisting condition: It eats away at the private insurance market on which it relies. That market cannot survive ObamaCare’s hubristic mandates, and ObamaCare cannot survive the collapse of that market. On their present course, both are doomed. The challenge for conservatives is to figure out how, upon the law’s repeal, to rescue private insurance. If conservatives don’t save that market, liberals will—only it will no longer be a market for private insurance, and there will no longer be millions of purchasers, but just one.

The two-year “Cadillac tax” delay under consideration by Congress is the worst kind of special-interest legislation. It will enrich labor unions and big business at the expense of taxpayers. ObamaCare’s Cadillac tax is a clunky but constructive first step in reforming the employer tax exclusion. It has problems—its structure as an excise tax is punitive, and it contains carveouts for favored Democratic constituencies—but the basic idea of equalizing the tax treatment of employer- and individually-purchased health insurance is a good one.

The 2015 United Auto Workers union contracts with General Motors Co., Ford Motor Co. and Fiat Chrysler Automobiles NV allow the companies to alter hourly-worker health plans if they are likely to trigger a 40% federal tax on some high-cost health-care plans. The most likely change: adding yearly deductibles for affected workers.

Instead of more federal regulation and subsidies, what U.S. health care needs is adoption of market principles, starting with broad empowerment of the patient-consumer. The proposals advanced in this volume would replace many counterproductive and outdated federal policies with practical, market-based reforms that aim to provide all Americans with access to high-quality health care at affordable prices.