There was no excuse for Congress and the president not to understand the fundamental flaws of “Obamacare.” There were warnings — some as early as before the 2008 election.
Will there be a “taxpayer revolt”? Maybe — especially when health insurance premiums for our younger, employed and healthy people double or triple in some states — this to pay for the heavily subsidized, i.e., “free” coverage for others. Aggravating this, many online applicants have learned how to “game” — or simply defraud — the application process to “qualify” for even more benefits.
The blatant financial discrimination against younger, employed and healthy Americans works two ways: First, many will have to pay for more health coverage than they may want or need; then, because they can “afford it,” the IRS-enforced “system” assesses them even more for it. An odd twist, perhaps, to the “Affordable Care Act,” i.e., because you can afford it — you pay. Second, the system then “takes” that “extra” premium money and uses it to pay for the same broad-based health coverage for others — again whether they want or need it or not.
Hence, the understandable and growing reaction among our employed, young and healthy population is simple: “We’re getting screwed.”
Yes, you are.
This approach was chosen for pure political and ideological reasons.
Next question: Will or can Obamacare survive politically?
Like most complex political questions, it all depends — and the devil is in the details. Here are just a few: The implementation, website and exchanges may simply break down under their own weight, with ever-increasing privacy, fraud and technical issues. Mostly ignored, of course, in the implementation of the Obamacare is that the regulation of the health insurance business is the province of the individual states, and has been since the 1940s. All health insurance companies do not operate in all states — nor do they want to, nor can they be required to. The effect of this for most Americans will be drastically different implementations of Obamacare in the various health insurance “exchanges.”
In other words, what the president said about Obamacare — that you can “keep” your coverage — has never been true. The president should have said: “You might be able to keep your current health insurance; however, the premiums will be much higher, especially if you are young, employed and healthy — it all depends on how much money you make and how the state you live in regulates its health insurance business. Good luck.”
Why was something so basically simple so poorly thought out and incompetently implemented? I say “simple,” because there are a number of basic and broad-based social health care and insurance reforms that could be the product of a broad political consensus. For example:
Eliminate “pre-existing condition” exclusions in all health insurance coverage. Increase age of dependents’ coverage. Address the “large loss,” major medical exposures, for the uninsured, with a system of “assigned risks” as with automobile liability insurance. Address a wider scale of school-age public health issues with specific programs, including the low-cost, basic coverage, college programs that many of us remember. Revitalize the U.S. Public Health Service. Allow young, employed people in good health to participate — without any penalty or income-based assessment — in basic coverage and “major medical” type plans with guaranteed portability. Increase the funding for Medicare and increase the eligibility — gradually — to age 70. Review and standardize state Medicaid programs.
Review and improve Medicare Part “D” prescription-drug coverage (This Bush administration program is hugely inefficient and was a “sellout” to the drug industry, guaranteeing high prices.)
In short, let’s “reset” politically and take our heath care insurance reform a step at a time. This is greatly preferable to Obamacare, with its transparent political agenda and socialistic “new order.” There is simply no future in penalizing our young, healthy and employed Americans to pay for broad-based social reform.
Daniel Gallington is senior policy and program adviser at the George C. Marshall Institute in Arlington. He usually writes about national security matters.