Written by Chriss W. Street
Despite the administrative turmoil in preparing to implement the law, supporters like to characterize the Patient Protection and Affordable Care Act (Obamacare) as a “work in progress” that only suffered a few glitches and needed a few tweaks. This reminds me of the implementation of the Medicare Catastrophic Coverage Act of 1988, where resentment grew after beneficiaries realized benefits of the new legislation added little to their existing coverage. For all of Obamacare’s controversy and costs, I believe the law will be repealed because after implementation the number of Americans without healthcare coverage will not decline.
As the White House and the Republican in Congress shut down the government over the implementation of Obamacare, 47% of Americans believe the fight is more about gaining political advantage than the 37% who believe the fight is an important battle over principles and the future direction of government according to Gallup polling. These views are similar to Americans’ attitudes on the day the government shut down in November 1995. When it comes to assigning responsibility for shutting down the government over Obamacare; 5% will blame Democrats, 14% will blame Obama, 25% will blame Republicans and 44% will blame them all.
The President Obama claimed that he compromised the design to achieve fiscally neutrality over a 10 year projection, to avoid increasing the deficit spending. But, to achieve this mirage, the implementation was delayed for 3 years and the premium cost was ramped up over the next three years. When the ACA was passed it was estimate that of the 45 million uninsured Americans, 35 million would gain insurance. But since passage, the United States has grown by 9 million people and the Administration now estimates that only 31 million new people will be covered. Even if the projection of 31 million new people covered is accurate by say 2017, we will still have (assuming further population growth) as many as 28 million uncovered people.
Under Obamacare’s design, 17 million out of the 31 million new people covered were going to go into the expanded Medicaid program. But with the Governors of many Southern and some Western States refusing to allow that Medicaid expansion, it appears that under Obamacare, only an additional 9 million new Medicaid enrollees nationwide. Many others will try to game the system, because they are willing to accept the fines for not joining Obamacare, rather than pay the cost of the lousy insurance offered for basic plans.
Consequently, only about 17 million of that original 35 million will be signed up for coverage next year. With the premiums doubling over the next three years until full implementation, some of those that signed up will drop out. When population growth is added in over that period, by 2017 there will still be 40 million Americans not covered by health insurance.
Less than a year and a half after enacting the Medicare Catastrophic Coverage Act of 1988, Congress was forced by a ground swell of negative public reaction to retract the legislation, the first major enhancement in Medicare benefits since the program’s inception in 1965. A retrenchment of this magnitude was unprecedented in social welfare policy. The experience soured Congress from enacting further increases in healthcare benefits for 20 years.
Medicare Catastrophic Coverage was popular when passed, whereas Obamacare was never favored by voters. Today only 36% of “Likely U.S. Voters” believe the government should require every American to buy or obtain health insurance according to the latest Rasmussen national survey. When the public learns Obamacare is not decreasing the number of uninsured, a ground swell of negative public reaction will force Congress to soon retract the legislation.
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