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

For decades, federal health policy — through taxes, spending, and regulation — has encouraged people to get their health insurance through their employers, and has encouraged them to choose health plans that pay for routine care. These policy decisions have inflated prices and made insurance harder to obtain for people who don’t have access to employer coverage, and especially for those who have chronic ill health. Obamacare attempted to fix some of these problems, mainly by adding an additional layer of government interventions and attempting to centralize the health-care system.

Jeb Bush’s new health-care plan looks a lot like the plan Scott Walker embraced two months ago, which in turn looks a lot like the one Marco Rubio sketched in an op-ed article and the one touted by Senators Orrin Hatch and Richard Burr and Representative Fred Upton. That’s a good thing. It means that Republicans are finally reaching a consensus on what to do about health policy that draws on the best conservative thinking on the subject. Bush (for whose campaign my wife works) is helping to ratify that consensus.

Today in New Hampshire, former Florida Gov. Jeb Bush unveiled his plan to repeal and replace Obamacare. In many ways, the plan reflects the mainstream of Republican wonk thinking on health care, and expresses similarities to an earlier plan proposed by Wisconsin Gov. Scott Walker. Like Walker’s plan—but in a different way—Bush’s plan seems likely to increase the deficit.

It has been clear for some time that Republicans need just two things in order to repeal Obamacare—a winning alternative and political willpower. The jury is still out on how much of the latter the party possesses. But when it comes to uniting around a well-conceived alternative that can pave the way to full repeal, the news is increasingly good. Jeb Bush’s just-released Obamacare alternative is the latest example of this encouraging trend.

Tonight, the first Democratic debate of the election season will kick off. With two GOP debates in the rearview mirror, the first of the debates on the left should offer an opportunity to see how the candidates will distinguish themselves. In particular, one issue that’s been largely absent (at least from the GOP debates beyond “repeal and replace”) is health care. In this coming debate, and in the later GOP debates, the moderators ought to seek out the candidates’ positions on a slew of health care issues.

Joshua Smith, a Rockland County insurance broker, was deluged with questions from clients after regulators said they were shutting down Health Republic Insurance of New York, which was known for having some of the lowest rates in the state.

“It’s been a week of craziness,” said Mr. Smith, who owns Vanguard Benefit Solutions LLC, which enrolled about 75 small businesses in Health Republic’s plans. “Lots of emails, lots of calls, and everybody is nervous about what is going to happen.”

In apparent recognition of the distinct unpopularity of the Affordable Care Act’s Cadillac tax—an excise tax on high-value, employer-provided health benefits—more than 100 economists have signed a letter defending it. As the Washington Post headline about the letter read: “101 Economists Just Signed a Love Letter to the Obamacare Provision Everyone Else Hates.”

Risk corridor data released on October 1 by the administration shows that insurers lost a lot of money on Affordable Care Act (ACA) plans in 2014. The ACA established a three-year risk corridor program to transfer funds from insurers with lower-than-expected medical claims on ACA plans, i.e., profitable insurers, to insurers with higher-than-expected claims, i.e., insurers with losses. Despite administration claims that incoming payments from profitable insurers would cover losses from unprofitable ones, the risk corridor program shortfall exceeded $2.5 billion in 2014. Insurers with lower-than-anticipated claims owed about $360 million, and insurers with higher-than-anticipated claims requested about $2.9 billion from the program.

One of the consumer complaints levied against Affordable Care Act (Obamacare) health plans is that their provider networks are often narrow,1 creating both a high ratio of patients to doctors2 and increasing the risk for out-of-network care.3 With respect to out-of-network care, when enrollees go out-of-network for healthcare, many Obamacare plans will not cover the costs except in the case of a medical emergency or if a prior authorization from the plan had been formally submitted and then approved by the health plan. Moreover, unlike in-network healthcare, out-of-network medical care does not have its annual costs capped by the Affordable Care Act to prevent catastrophic medical expenses.

A recent poll by Rasmussen revealed that just 37 percent of likely U.S. voters believe the government should mandate that every American have health insurance, down four percentage points from its previous poll and the lowest level of support since December 2013. In addition 52 percent of Americans now oppose government-mandated health insurance, the highest it has been since that December 2013 poll.