What is ObamaCare? It is a combination of two public laws, H.R. 3590, the Patient Protection and Affordable Care Act, and H.R. 4872, the Health Care and Education Affordability Reconciliation Act of 2010. Given its complexity and reach, the recently enacted health care laws almost seem to defy summarization and comprehension.
And it is of course true that the new legislation is filled with scores of detailed prescriptions touching nearly every corner of American health care. The implications of most of these provisions will only be fully understood if and when they are made operational.
Even so, it is not necessary to describe every section and subsection of the law to understand the core and flawed logic of the broad ObamaCare project.
Fundamentally, ObamaCare is built around a small number of key changes in the way health insurance is arranged for working age Americans and their families.
Today’s employer-based system of insurance works reasonably well for the vast majority of working aage people and their families, but it leaves gaps for some because the insurance is not portable, small employers have a more difficult time securing stable options, and low-wage workers sometimes cannot afford the premiums because costs are high relative to their incomes and rising rapidly.
Instead of attacking the primary problems — lack of portable insurance owned by the policy holder and costs driven upward by excessive federal subsidization — ObamaCare leaves the flawed policies in place and attempts to coerce coverage of the remaining uninsured with a heavy-handed governmental structure. This structure is said to be targeted in a way that helps those without coverage without disrupting everything else. But that is not true. Once in place, the key ObamaCare reforms will inevitably put the federal government in the driver’s seat over the basic direction of all American health care.