“It’s the great moral imperative behind the Affordable Care Act (‘Obamacare’): People should not be denied health care because they can’t afford insurance. Health status and insurance are assumed to be connected, and opponents have often been cast as moral midgets, willing to condemn the uninsured to unnecessary illness or death. The trouble is that health status and insurance are only loosely connected. This suggests that Obamacare may result in more spending and health services but few gains in the public’s health.”

“During the health care debate, liberals argued that government had a moral duty to enact legislation that expanded health insurance among lower-income individuals. This was rooted in the assumption that obtaining health insurance translates into improved health. But a landmark study published in the New England Journal of Medicine dramatically undermines this assumption and shatters the rationale behind the law’s Medicaid expansion.”

“There is no way to spin these results as anything but a rebuke to those who are pushing states to expand Medicaid. The Obama administration has been trying to convince states to throw more than a trillion additional taxpayer dollars at Medicaid by participating in the expansion, when the best-designed research available cannot find any evidence that it improves the physical health of enrollees.”

“Hospitals that treat the most vulnerable patients may have the toughest time weathering spending cuts under President Obama’s health-care law… Under the Affordable Care Act, the safety-net hospitals will gain a new source of revenue when millions of the uninsured gain coverage. At the same time, the law’s spending cuts could prove challenging for hospitals that tend to operate with relatively small profit margins.”

“House GOP leaders asked President Obama Tuesday to make funds available in support of a temporary insurance plan for people with pre-existing conditions. The plan, known as PCIP, has struggled to get off the ground since it was enacted as part of the healthcare law. Last month, the Obama administration announced that it would close enrollment due to concerns that the program would be too costly.”

“Tens of thousands of Americans who cannot get health insurance because of preexisting medical problems will be blocked from a program designed to help them because funding is running low. Obama administration officials said Friday that the state-based ‘high-risk pools’ set up under the 2010 health-care law will be closed to new applicants as soon as Saturday and no later than March 2, depending on the state.”

“Universal Orlando plans to stop offering medical insurance to part-time employees beginning next year, a move the resort says has been forced by the federal government’s health-care overhaul. The giant theme-park resort, which generates more than $1 billion in annual revenue, began informing employees this month that it will offer health-insurance to part-timers ‘only until December 31, 2013.'”

“The fundamental flaws in our system are familiar: perverse incentives that encourage excess treatment, high prices, poor service (even dangerous sloppiness), incomprehensible complexity and a flawed safety net. But to all such problems the new health-care law has the same two answers: more insurance and Medicaid and more top-down cost control.”

“As we have seen, the same bill that insures 32 million new people also will force middle- and upper-middle-income families to have more generous coverage than they now have. As these more generously insured people attempt to acquire more medical services they will almost certainly out-bid people paying Medicaid rates for doctor services and hospital beds. To make matters worse, the health reform bill did nothing to increase the supply side of the market to meet the increased demand.”

“Obviously not everyone will make the choice to go uninsured. People who are risk-adverse, or who have ongoing medical needs, or who have small children, will continue to be covered. But every year, every person will have to decide how best to spend their money. A very large number will decide they have better things to do with that money than spend it on insurance coverage they don’t want and never use. The odds are that after all the trauma and expense of enacting and implementing ObamaCare, we will have fewer people insured than we did before it was enacted.”