Time For A Check-up: Four Years of Obamacare

This past month marked the four-year anniversary of President Obama signing the Affordable Care Act into law. It’s been a bumpy ride for both parties, with Republicans struggling to devise convincing alternatives and Democrats dealing with delayed deadlines and faulty websites. Both sides have their respective success and horror stories, and have carefully selected the data that serves them best for the upcoming midterm elections.

Amongst all this kerfuffle and brouhaha, rarely do we take the time to step back and look at the last four years with perspective. Perhaps a more comprehensive look at the landscape of Obamacare will help gain a more meaningful understanding of its effects.

The whole idea behind a nationalized healthcare revolution was that consumers were frustrated with the market approach as it stood. Issues like pre-existing conditions, required emergency room care, Medicare and Medicaid emerged as the hot-button issues that the government saw as problems only they could fix. But therein lies one of the major problems.

Nationalized healthcare was a response to the need for healthcare  insurance, not primarily a need for increased healthcare quality. This seems to have created a sense of cognitive dissonance in the minds of many Americans, as the concept of government-run healthcare does not and cannot mean better service. Sure some individual premiums may go down, but the kind of quality healthcare that consumers are looking for will inevitably be found wanting.

As to the overall success of the law to date, Democrats have boasted an approximated 6 million sign ups ever since the administration learned how to create a website. 6 million? Sounds like a big number. However, an overwhelming minority are first-time holders, according to reports by McKinsey & Co. When this is combined with the number of enrollees who have yet to actually pay for their plan and those who just signed up for Medicaid, 6 million becomes very insignificant very quickly.

In addition, according to a recent study by Pew Research, Obamacare’s approval rating is below 50% in the vast majority of demographic categories. And it still hasn’t even taken full effect! With how much difficulty the administration has had just getting the law off the ground amongst multiple delays and technical difficulties, the thought of implementation is nothing short of frightening. And over half of the country seems to agree.

So how has the ACA fared in its pediatric checkup?

  • The compromises for cheap service are detrimental.
  • Initial traction is fractional.
  • Overall approval is dismal.

Unfortunately, it’s going to take more than a Platinum Plan to cover this system. Four years out, we’re learning the hard way that insurance coverage is not the same thing as health care.

And for fun, check out The Heritage Foundation’s spoof on the Obamacare ad campaign to get covered:

States Call Obamacare’s Bluff

Imagine you’re asked to go to dinner, and your dinner date chooses your entire meal for you (of course, he claims his choices are the best the menu has to offer, regardless of your gluten allergy or dislike of rare beef). You enjoy the meal regardless your impending indigestion—until the check arrives. He asks you to pick up the whole tab and, while you’re at it,  leave a generous tip.

Beyond ObamacareAccording to state policy analyst Nicole Kaeding, this scenario is a lot like the state-run healthcare exchanges suggested by the Patient Protection and Affordable Care Act (Obamacare). An exchange is a government-controlled, Web-based health insurance marketplace. But unlike an innovative, free marketplace that adjusts to consumer demand, a government-run exchange will be fraught with regulations and mandates. Not to mention a slew of tax increases and increased costs carried by consumers and business-owners in the state.

Today is the deadline for states to decide whether or not they will build a state-run healthcare exchange or leave the set up of exchanges to the architects of the federal program, the Department of Health and Human Services.

On Wednesday, Governor Corbett of Pennsylvania announced that his state will refuse to implement a state exchange . The Commonwealth Foundation’s blog explains why this is a good choice for Pennsylvania and other states:

1. A state-run exchange offers only the illusion of state control. The Department of Health and Human Services can change regulations at any time, effectively having complete control over state governments in regards to health insurance regulations.

2. Costs would be borne by state taxpayers. States will shift the administrative costs to consumers through a new user fee or higher premiums. Some states have estimated this cost to be between $30 and $50 million per year. To fund the federal exchange, HHS will impose a 3.5 percent fee (tax) on all insurance plans sold on the exchange-a charge that will certainly make insurance that much more costly.

3. Exchanges don’t create more robust competition. The mandates and regulations tied to the federally-approved exchanges means less competition, as all health care plans will be pretty much the same.

4. Exchanges won’t lower the cost of insurance. While the law was intended to make health care more “affordable,” the real-world evidence suggests that isn’t happening. Even the most ardent Obamacare backers recognize that “premium growth, although slower than in years past, continues to outpace inflation and wage growth.”

Here is the run-down of where other states stand on exchanges from ABC News:

  • 23 states that have opted out: New Jersey, South Carolina, Louisiana, Wisconsin, Ohio, Maine, Alabama, Alaska, Arizona, Georgia, Pennsylvania, Kansas, Nebraska, New Hampshire, North Dakota, Oklahoma, South Dakota, Tennessee, Texas, Wyoming, Montana, Indiana, and Missouri.
  • Utah already has an exchange, and is still waiting to see if HHS and the White House are going to impose rules and regulations on their existing system.
  • 19 states are establishing state-based exchanges: California, Colorado, Connecticut, Washington, D.C., Hawaii, Idaho, Iowa, Kentucky, Maryland, Massachusetts, Minnesota, Mississippi, Nevada, New Mexico, New York, Oregon, Rhode Island, Vermont, and Washington.
  • 6 federal-state partnerships: Arkansas, Delaware, Illinois, Michigan, North Carolina, and West Virginia.
  • Virginia and Florida are undecided.

Who are the guardians of the people’s liberty?

James Madison

James Madison

There exist opposing views on the roles of public servants. One holds that it is government’s duty to ensure freedom from all fear and want, which was made [in]famous in Franklin D. Roosevelt’s Four Freedoms speech. This sounds like a lovely sentiment—until it comes at the expense of personal liberty. We can see this worldview in action with the huge growth in entitlement spending and expressed in the posters of the Occupy movement, i.e. “Where is my bailout?”

The other regards public servants as guardians of the people’s liberty. This idea is rooted in the philosophy of Thomas Jefferson and James Madison, among other American founders. Just in case future elected officials lost sight of the founders’ intent, they had the foresight to protect it in the Constitution. Included in this was the federalist structure, or separation of state and federal power to protect personal liberty.

In a speech to Congress in 1789, James Madison said this about the role of state government in talking about our Bill of Rights:

… the state legislatures will jealously and closely watch the operation of this government, and be able to resist with more effect every assumption of power than any other power on earth can do; and the greatest opponents to a federal government admit the state legislatures to be sure guardians of the people’s liberty.

It appears we have forgotten Madison’s lessons. Power is terribly out of balance, and we see an increase in executive orders and regulatory agencies asserting power over the states decade after decade. However, we still can still devolve power from Washington and bring it back to the states—and ultimately back to the people. In fact, there are “guardians of liberty” who are hard at work to accomplish this feat.

Stay tuned as we explore current battles for freedom on this blog:

  • Attorneys General from Arizona, Florida, Georgia, Michigan, Oklahoma, South Dakota, South Carolina, Texas, and Virginia file suit against the federal government for overstepping the bound of the Constitution. See the list of violations here.

Do you know of any other guardians of liberty?