A while back I wrote that it was an unwise move for the conservative wing of the Republican Party to try and defund the Affordable Care Act (ACA, commonly referred to as Obamacare.) In fact, it was I who was wrong–dead wrong. Here’s why.
My unstated assumption was that the ACA, given three years, essentially unlimited funding, and access to the brightest geeks of Silicon Valley, would roll out without a hitch. For that reason I ignored the suggestions that the ACA was a “train wreck.” I dismissed the Tea Party’s pitchfork and flame torch calls to sabotage the ACA as extreme partisan gestures. Though it seemed economically unsound, I resigned myself to the belief that the law was legitimately enacted, and, anyway, that it is highly difficult to predict all the impacts of such a wide ranging piece of legislation. Hell, maybe the Affordable Care Act would end up doing some good. Nevertheless, said the conservative in me, I would continue to buy private insurance because when I think of the mountains of debt this nation has accumulated in the name of Welfare, Medicare and Medicaid, I can only think of my four nephews who, neglecting any changes by mine and my parent’s generations, will eventually have to slay the Typhon of dependency.
After all, it was repeated ad nauseam that “If you like your healthcare plan, you can keep it.” My wife and I are among the 14 million Americans who purchase private health insurance. Our monthly premium a few months ago was $186. It has now jumped to $252. We do not plan to have children for several years—we would like it if we were not forced to purchase a plan with maternity care. We are also fairly confident that we won’t suddenly take up cocaine or heroin and need a plan that covers substance abuse disorders. We neither need nor want these services, but they are both required under the ACA.
Still, a chance remains that our current healthcare plan may not be up to par with what the Overlords in Washington say, and that it may get canceled. NBC recently reported that as many as 80% of those with private health insurance may lose it. Ignorant of the Fast and the Furious scandal, Benghazi, and the plethora of NSA operations, President Obama was evidently aware that his signature achievement would have this result.
But my wife and I are very fortunate to have degrees without debt, and an income that can absorb the changes. I imagine we are rare in that respect.
However, the White House maintains it hasn’t forced anyone off of their plans; that if an insurance carrier modified their plan in any way (one imagines various actuarial tweaks are routine maintenance carriers perform) then they will have ended it on their own. This is because the ACA only permits unchanged plans to stay with customers, not modified or new ones. It is just another example of how the White House has swindled everyone into believing that Washington knows what’s best for them.
In addition to the paternalistic animus of the ACA, technical problems have caused a bad system to function even worse than initially planned. As the Washington Post’s Ezra Klein reported a few days ago, no one knows the extent to which other ends—apart from just the consumer interface at the healthcare website—of the system are compromised. Numerous problems have resulted from the website misreporting all sorts of information to insurers. Moreover, Klein reports that a number of enrollees desperate to get insurance coverage will, in fact, patiently await the system. The number of healthy and insouciant young people may be turned off to the system and fail to return. Premiums for the elderly and the sick would then rise. The ACA may raise the minimum standards of healthcare, but what good is that if none can afford it?
It seems to me the same phenomenon with college. Schools regularly convince students that the only option following graduation is to attend college. The rich can afford it. The poor have it subsidized through grants. The kid with middle class parents is too rich for grants and too poor to pay it for himself. So he takes a loan, graduates with a fine arts degree, and starts life $50,000 in debt. For healthcare, the middle class citizen too poor to pay full price and who doesn’t qualify for subsidies will face exorbitant premiums. If he cannot afford them, he will be fined by the government for his inability to pay for the very healthcare the government mandated. What sense, honestly, does that make?
Given Nancy Pelosi’s insistence that we had to sign the Affordable Care Act to see what was in it, a more appropriate title would have been Pandora’s Bill.