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

A new poll conducted for POLITICO and the Harvard T.H. Chan School of Public Health finds that 54 percent of likely voters think Obamacare is working poorly. Ninety-four percent of self-identified Donald Trump voters hold that view, while 79 percent of Hillary Clinton supporters believe the law is working well.
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President Obama promised that the Affordable Care Act would increase competition and choice in insurance markets. In a 2009 speech to a joint session of Congress, for example, the president said, “Individuals and small businesses will be able to shop for health insurance at competitive prices. Insurance companies will have an incentive to participate in this exchange because it lets them compete for millions of new customers.” This claim, along with many othersmade by ACA supporters, have proven to be wrong. In fact, Americans have far fewer choices for individual market coverage today than they had before the ACA took effect and there is a rapidly declining number of insurers now offering coverage in the ACA exchanges.

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Those on both the left and the right overestimated the effect Obamacare would have on the larger health care system. The footprint of Obamacare has been smaller than expected. It hasn’t shaken up the employer system all that much, and it hasn’t changed the underlying health system as champions and critics thought it would. It hasn’t reduced the uninsured as much as expected and (therefore) hasn’t cost as much as expected overall even though per capita costs are higher than projected. The exchanges have drawn far too few healthy people to be stable and the rules that govern them have had too little of an effect on the dynamics of our larger health economy to be fundamentally disruptive.

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The Trump campaign has doubled down on Health Savings Accounts, the health-insurance-as-401(k) product the Affordable Care Act was supposed to extinguish but which was specifically saved by President Obama in order to provide Americans with a health insurance option they could actually afford. The ACA specifically delegates the important job of defining what is and what isn’t health insurance to the Department of Health and Human Services. A President Trump could use that authority to greatly expand the role of HSAs in the exchanges and in entitlements, limited only by changes in budget such revision might entail.

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Next year’s enormous premium increases are merely the latest expression of Obamacare’s underlying problems, and the dysfunction is undermining the health security of Americans who lack employer coverage. A wave of major insurers have quit the exchanges, and those that are left have raised deductibles and copays and restricted choices of doctors and hospitals. The only way to break the Obamacare status quo is if the public returns a Republican Congress to Washington. If Republicans can hold the Senate amid a Clinton victory, they’d be in a better position to negotiate solutions along the lines of the House GOP “Better Way” blueprint that would start to repair the individual market and create incentives for more choice and competition.

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In 2008, the year that Barack Obama was elected as president, the combined annual profits of America’s ten largest health insurance companies were $8 billion. Under Obamacare, the ten largest health insurers’ annual profits have risen to $15 billion. This is another fine example of the natural alliance between Big Government and Big Business, which flourishes at the expense of Main Street Americans.

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A top administration official said customers facing big Obamacare premium increases next year will need to shop around to find a cheaper plan, despite some states having only one insurer offering plans.

Health and Human Services Secretary Sylvia Burwell told CNN anchor Wolf Blitzer Tuesday that the premium hikes, which will average 25 percent across all Obamacare plans, won’t be so bad for customers.

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The Affordable Care Act is in the midst of the death spiral critics have long predicted. Before it enters the final death throes, Republicans must publicize viable market-based alternatives to replace it. That is the only way to avoid the potentially disastrous government-run, single-payer health-care system that would result from Hillary Clinton’s and President Obama’s policy proposals.

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Some states with tight Senate races are seeing their Obamacare rates climbing next year even more than the average 22 percent increase announced by the Obama administration on Monday, as Republicans use the spikes to try to get the upper hand in a close battle for control of the chamber.

Two states with very tight Senate races are facing big increases: Pennsylvania with 53 percent and North Carolina with 40 percent. Incumbent Sens. Pat Toomey in Pennsylvania and Richard Burr in North Carolina are in close re-election battles.

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House Republicans are questioning how much taxpayer money is going into federal subsidies meant to make insurance coverage more affordable for low-income Americans

Reps. Fred Upton (R-Mich.), Joseph Pitts (R-Pa.) and Tim Murphy (R-Pa.), all leaders of the Energy and Commerce Committee, sent a letter Monday to Andy Slavitt, acting administrator of the Centers for Medicare and Medicaid Services, requesting information about the amount of taxpayer money that will go toward Obamacare subsidies next year.

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