The loss of what remains of Americans’ health care freedom is an election away. For the Obamacare of today to be transformed into the Hillarycare of 1993 and finally into a nationalized health care system, a president is needed who has the willpower to impose the coercive details, nail down hard deadlines and unleash agencies to tighten controls and squeeze the life out of private insurers. In 1993, Hillary Clinton unapologetically proposed to do just that. If she is elected president, she will have the unilateral power under Obamacare to do it.
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Obamacare is collapsing. Its utter failures become more obvious by the day. We all remember the promises of Obamacare, chief among them that the “Affordable Care Act” would lower health care costs. The opposite has occurred. Despite the offer of subsidies through the exchanges, enrollment in Obamacare has been dismal. Younger, healthier individuals have little interest in paying exorbitant premiums for insurance plans that come with $5,000 deductibles. The result has been an unbalanced insurance pool where insurers must charge ever-increasing premiums to continue offering coverage.
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The problems emerging in the exchanges are a symptom of a larger disease, which is that the ACA moved far too much power and regulatory control over the health sector to the federal government. Building a broader consensus around reform of the individual insurance market will almost certainly require revisiting other fundamental aspects of the ACA that have sharply divided policymakers.
The ACA exchanges will not be able to continue indefinitely without substantial reform. But reform will only be possible if the American public believes that this will not merely be another intrusion into their personal health decisions and their wallets. It will be up to Congress and the next President to decide if America’s health care system is worth the political risk needed to enact responsible and necessary reforms.
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As Hillary Clinton, President Obama, and most Senate Democrats coalesce around a government-run insurance agency as part of the solution to Obamacare cost woes, a large problem remains unaddressed: Insurers hate the public option.
Democrats, including the Clinton campaign, are showing little sympathy.
In recent months, several insurance plans have pulled out of Obamacare exchanges, citing losses. Many areas of the country will see double-digit premium increases in 2017 as insurers try to recoup their losses and bring rates in line with medical claims. The insurance industry has made it clear that participating in exchanges has, thus far, not been easy.
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Several RAND Corporation health economists have offered very rough estimates of the coverage and cost effects of the hazy health policy proposals by the two major presidential candidates, Hillary Clinton and Donald Trump. In choosing to fill Trump’s policy vacuum with their own void of limited health policy modeling, the RAND researchers conclude that Trump’s proposals would increase the number of uninsured individuals within a range of 16 to 25 million individuals (relative to current-law ACA arrangements), with disproportionate losses suffered by those with low incomes or in poor health. However, Trump doesn’t spend much more taxpayer money to achieve these results, and his plans in health policy would increase the federal deficit by somewhere between $0.5 billion to $41 billion.
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With major insurers retreating from the federal health law’s marketplaces, California’s insurance commissioner said he supports a public option at the state level that could bolster competition and potentially serve as a test for the controversial idea nationwide.
“I think we should strongly consider a public option in California,” Insurance Commissioner Dave Jones said in a recent interview with California Healthline. “It will require a lot of careful thought and work, but I think it’s something that ought to be on the table because we continue to see this consolidation in an already consolidated health insurance market.”
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Hillary Clinton surely is hoping health reform remains a side issue the presidential campaign as bleak news of its failures have propelled Obamacare back into the spotlight. Clinton owns Obamacare after telling Iowa voters: “I will defend the Affordable Care Act, but as president I want to go further.” She actually wants to double down, even after seeing public support for the health law tumble. She wants to create another big government “public option” that would have unlimited calls on taxpayer dollars and government force and would quickly drive remaining private insurers out of the market, leaving people with only the “choice” of a government-run health plan. We can and must do better than Obamacare, and the voters know it.
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Senate Democrats and liberal groups are unveiling a new push to add a public option on ObamaCare on Thursday.
The effort is led by senators including Chuck Schumer (D-N.Y.), on track to be the next Democratic leader, and Bernie Sanders (I-Vt.), who galvanized liberals in his presidential campaign with a push to go even further and set up a “Medicare for all” system. Sen. Jeff Merkley (D-Ore.) is spearheading the effort.
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What happens to Obamacare after its namesake leaves the White House? The Affordable Care Act (ACA) has faced fierce opposition from congressional Republicans and many GOP-led state governments, survived unexpected legal challenges, and overcome a disastrous rollout of healthcare.gov. Through it all, ACA supporters could count on President Barack Obama to defend the law. But come January 20, 2017, that will change. If Donald Trump becomes president and Republicans maintain congressional majorities, the GOP could seek to repeal major ACA provisions, though Trump’s health care agenda is uncertain.
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