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

Last week, the Centers for Medicare and Medicaid Services released its official estimates of the uninsured population and of health spending. In 2014, ObamaCare’s coverage expansion fell between 6 and 12 million short of expectations, while driving the growth of health spending to its highest rate in 7 years. ObamaCare has only reduced the percentage of U.S. residents without health insurance by about 2%: a remarkably small number, and far lower than what the law was supposed to achieve.

The Justice Department last month asked the Supreme Court to review a preliminary injunction blocking the Obama administration from implementing the president’s immigration executive order, which would defer deportations for up to five million undocumented immigrants. Employers aren’t required to offer ObamaCare coverage or subsidies to these immigrants. The statutory language in the Affordable Care Act says that only “lawful residents” are eligible, and the government’s petition specifically notes that the immigration action does not “confer any form of legal status in this country.” In short, companies will be encouraged to hire these immigrants over U.S. citizens.

ObamaCare is performing worse than expected when it became law: plans are less attractive, enrollment is lower, premium increases are higher, and risk pools are sicker. Medicaid expansion is a key problem with the law. The main problem with Medicaid, which existed before the ACA took effect, is that enrollees receive little value from the program. The joint federal-state health care program needs large scale reform so that it provides better value for both enrollees and taxpayers.

Democrats like to talk a lot about being the party of choice, but under Obamacare, individuals are finding their choices increasingly limited. At its core, Obamacare forces individuals to purchase government-approved insurance policies and precludes them from buying plans that might be more in line with their healthcare needs. Though Obamacare’s defenders argue that the requirements imposed on health insurance plans only serve to guarantee that individuals have better coverage, in reality, what’s happening is that the law is driving insurers to limit choices.

The GOP has big reasons to move ahead with sending an ObamaCare repeal to President Obama’s desk: it will force the president to veto the bill, will fulfill a promise to its base, and will lay the groundwork to truly repeal the health care law under a Republican president in 2017. It’s not just optics. Republicans are carefully constructing a legislative strategy, based on Senate rules and precedents, to make it easier to unravel the health law in 2017 if a Republican wins the White House.

The Senate voted to repeal the Affordable Care Act and defund Planned Parenthood Thursday evening, clearing a nearly six-year hurdle that kept previous attempts to undo the health care law from reaching President Obama’s desk. Though the president has vowed to veto the bill, it passed 52-47. The legislation would repeal major parts of the president’s signature policy achievement, including the individual and employer mandates and Medicaid expansion, which would be aborted after a two-year delay.

Aware of the unsustainability of rising health care spending, policymakers have sought to implement myriad policies and programs aimed at reducing such spending growth. One such attempt is the Independent Payment Advisory Board (IPAB) authorized under ObamaCare. However, IPAB’s statute limits its ability to achieve long-term success. IPAB is not likely to be successful in reducing health care costs without having harmful effects on Medicare beneficiaries.

U.S. health care spending last year grew at the fastest pace since President Obama took office, driven by expanded coverage under his namesake law and by zooming prescription drug costs, the government said Wednesday. The report by nonpartisan experts at the Department of Health and Human Services is an annual snapshot of the nation’s health care system, a major slice of the economy. Rising spending eventually has consequences for taxpayers, employers and individuals.

A narrow majority of physicians say Obamacare has a negative impact on medical practice, including on the quality and cost of health care, according to a report from the Journal of the American Medical Association. The report found that 52 percent of physicians look on Obamacare as unfavorable to the general medical situation, while 48 percent say it is favorable.

States increased their spending in fiscal year 2015 by the biggest margin in more than 20 years, but most of the increase was thanks to huge leaps in Medicaid spending under the first full year of the Affordable Care Act. Spending increased last fiscal year, which ended on June 30 for most states, by 7.8 percent, according to new estimates from the National Association of State Budget Officers (NASBO).