The impact of ObamaCare on doctors and patients, companies inside and outside the health sector, and American workers and taxpayers
Obamacare is back in court.
This month, the U.S. District Court for the District of Columbia ruled that the Republican-controlled House of Representatives has standing to sue the Obama administration over how it spent federal money implementing the Affordable Care Act. The lawsuit, brought by House Speaker John Boehner (R-Ohio), challenges billions of dollars the administration gave to insurers to reduce out-of-pocket costs for almost 6 million low-income Americans.
Health insurance premiums are rising because of Obamacare. And there is still one year left of the assorted reinsurance programs designed to mask premium increases, suggesting next year’s jumps will be even more eye-popping. That’s a political and logistical disaster for the Democrats who wrote the law and tied their political fortunes to its success. But rather than admit their law is too restrictive and come to the table to negotiate bipartisan reforms, Democrats and their insurance industry allies have decided on a cynical strategy: scapegoating drug companies.
Some Republicans are eyeing repeal of Obamacare’s “Cadillac tax” as part of a larger plan to roll back some of the law’s most unpopular and unworkable provisions. It is certainly a good idea to move legislation this year that begins to push back against Obamacare’s many excesses. But the Cadillac tax is the last provision Republicans should be targeting for repeal right now, and they certainly shouldn’t repeal it without replacing it with something more sensible.
The Census Bureau has finally released definitive statistics on the number of uninsured in 2014 and the news is not good for Obamacare (unless, of course, you have abysmally low expectations for government performance). The population-wide uninsured rate fell from 14.5% in calendar year 2013 to 11.7% in 2014. The total number of uninsured dropped from 45.2 million in 2013 to 36.7 million in 2014–a net of 8.5 million who gained coverage.
What a difference four years — and millions of people with health insurance — can make in the Republican presidential campaign.
In 2011, the last time GOP candidates for president gathered for a debate at the Ronald Reagan Library, the topic of the Affordable Care Act came up early and often.
Sitting in his bunker-like chambers in the Speaker’s Office, he admitted to looking a little glassy-eyed. “It was an early morning,” he said, but when you have an 18-month-old, most mornings are. While Jacob, his youngest, will soon age out of 4 a.m. wake up calls, Edattel and his wife are expecting their third, a girl, in December.
And because he’s House Speaker John Boehner’s new health policy guru, his early mornings will be bookended by late nights.
In its annual report on poverty and the uninsured, the U.S. Census Bureau reports that: “The percentage of people without health insurance coverage for the entire 2014 calendar year was 10.4 percent, down from 13.3 percent in 2013. The number of people without health insurance declined to 33.0 million from 41.8 million over the period.” (Our analysis shows that virtually all of the increase in the number of people with health insurance has come from Medicaid expansion.)
A few months ago, Tracy Raymond, a first-grade teacher in Palm Beach Gardens, FL, discovered that she was too fat for her school. A 50-year-old mother of two, Ms. Raymond has always carried around extra padding, but it never bothered her. “I know I’m heavier than I should be for my height, but I’m not obese,” she says. “I really don’t care.”
If the diet police has its way, she might have to start caring. Because according to her employer, her weight is a big problem—so much so that she was warned that if she didn’t lose weight and lower her cholesterol, either by participating in a wellness program or fixing the problems on her own, her insurance premiums would increase by $50 a month.
In King v. Burwell, the Supreme Court held that the Patient Protection and Affordable Care Act (ACA) should be read to authorize tax credits for the purchase of health insurance in exchanges established by the federal government lest the ACA’s other reforms destabilize the individual health insurance market in states served by federal exchanges. In “King v. Burwell and the Triumph of Selective Constitutionalism,” Michael Cannon and I dissect the court’s reasoning in King, highlighting the court’s abandonment of textualist principles (as others have noted) and the court’s reliance on a highly selective use of context to support its ultimate conclusion.
CBO and JCT have completed a preliminary estimate of the net budgetary effect of eliminating the requirement that individuals purchase health insurance and associated penalties established by the Affordable Care Act. We estimate that eliminating that requirement and the associated penalties would reduce the deficit by about $305 billion over the 2015-2025 period. That total consists of a $311 billion decrease in direct spending partially offset by a $6 billion decrease in revenues. Please see the attached table for year-by-year budgetary effects and a summary of the effects on health insurance coverage.