The American Interest
Analysis by Walter Russell Mead & Staff
Obamacare Round-up: ACA Support in a Death Spiral

obamacare

With each passing year, people are becoming warier and warier of Obamacare. WSJ has the results of a new survey on attitudes toward the ACA conducted by Mercer. It found that only 9 percent of companies now believe Obamacare won’t raise their health care costs significantly, compared to 20 percent last year and 25 percent in 2011.

Maybe, just maybe the decline in support has something to do with the information we’ve gotten in recent weeks about the likely costs of insurance under the ACA. It’s becoming clearer every day that the rates on the California exchanges are going to be too high for many Americans, President Obama’s celebratory remarks on California’s lower-than-expected premiums notwithstanding. Even ACA supporters are now saying that the rates are too high. The LA Times reports:

“In many cases, the networks are too limited and the prices are too high in the exchange,” said Jamie Court, president of Consumer Watchdog, a Santa Monica advocacy group. “Covered California doesn’t take the place of a government agency that has the power to force justification of the rates or deny them.”

Declining support for and increased anxiety about the ACA is bad news for the President because it’s self-fulling in a way: the more the public distrusts Obamacare, the less likely it is that people will sign up for insurance—and the more likely in turn that the law will fail. But there’s perhaps an even more immediate problem for the law hitting the news today. Many insurers aren’t signing up to offer plans in the small business exchanges. Politico:

Early looks at insurance offerings on the Obamacare exchanges show that insurers aren’t exactly signing up in droves to sell on the new Small Business Health Option Program exchanges. In some states, just one insurer has signed up for the SHOP exchanges, which are supposed to foster competition and make it easier for small businesses to purchase coverage.

Supporters of the ACA argue that all of these problems are just initial quirks that will work themselves out over time. They may be right, but the longer these stories the last, the less likely they are to work out in the ACA’s favor.

How long can the American public hold its breath?

Published on June 14, 2013 8:00 am
  • ljgude

    No need to hold our breath. With the ACA built on top of the foundation of US Healthcare costing somewhere between 16% and 17.5% of GDP it is unsustainable. If these predictions of insurance costs are accurate that percentage will jump despite the law’s capping the percentage at 17.5%. In any case even if these insurance cost problems prove to be teething problems and things settle down I think it is inevitable that medicine will become more unaffordable in the ACA environment. Even Switzerland which has a similarly structured insurance based plan only spends around 11% of GDP.

  • http://inthisdimension.com/ Alexander Scipio

    Two comments.

    1. The goal of Obama (& Pelosi) always has been Single Payer. It’s difficult to conclude the coming failure of ACA wasn’t a planned intermediate step. In fact, in order to conclude otherwise one must believe Obama & Pelosi are extremely stupid. Those two may be many things, but stupid is not one of them.

    2. Look at the privacy exclusions for gov, the public database requirements, the ability to access everyone’s bank accounts, etc., etc. ACA was never about healthcare. Had it been, Congress would not have exempted themselves (or used it to payoff college loan debt of their families & staffs). ACA is about control. Nothing more or less. Healthcare is a means to an end. That end is greater control over everyone. Single Payer will have even MORE control.

    • lukelea

      Agreed. Except I think control is good. Beats out of control which is what we have now.

      • https://www.facebook.com/ritchietheriveter Ritchie The Riveter

        Not if those in control can’t differentiate between YOUR individual needs and the statistical average …. which the limits of human perception and the need for equal protection under the law necessarily lead to when you allow government to do such things FOR you.

        And that’s if they still respect your rights at all … I have long said that Obamacare/single-payer progression has the potential to make the PATRIOT Act look downright libertarian by comparison, and I see nothing yet to change that assessment.

    • Corlyss

      I agree with you that was the end goal of Obama care. It staggers the imagination to think that they could pull off such a massive operation, but stranger things have happened. All the industrialists that supported Hitler thought he was a controllable crackpot who would never do what he said in Mein Kampf he was going to do. And who looking into Germany in 1934 would have had the foresight to perceive a Europe in ruins in 1945?

  • lukelea

    Good reporting. “Wait and see” has always been my attitude towards Obamacare for the simple reason that I’ve never had a clear idea about what it really is. Now I’m beginning to wonder if anybody did, including the people who wrote the bill.

    “Medicare for all” at least has the advantage that it is easy to understand. And if there were no other alternatives how could doctor’s possibly refuse to take Medicare patients.

    America already has a good healthcare system. The only problem is that it costs too much.

    • John Stephens

      “…how could doctor’s possibly refuse to take Medicare patients?” Easy. I’m fairly certain there’s no Constitutional way to prevent doctors from establishing cash only practices.

      • Corlyss

        Here’s the sinister long term objective of Obamacare, after they’ve destroyed the insurance companies by controlling the premiums they can collect, the criteria for insureds, their reimbursement liability, and treatments they will be obligated to underwrite. Eventually the government will become the sole source of medical doctors in the US. The feds will attempt to address the doctor shortage created by Obamacare by contracting to pay all of med students’ educational costs in return for their agreeing to serve at a set salary wherever the government needs to send them.

        • Rich K

          Or they will do what they do in Canada and Import them from India, on the cheap.

          • Corlyss

            That too.

      • http://www.facebook.com/southwestern.songdog Southwestern SongDog

        You need to have somebody explain Wickard v. Filburn to you.

        • Corlyss

          One of the most dangerous precedents in SCOTUS’ catalogue. Why? Because not only was it foolish, it was the product of cowardice. Additionally, with the almost century-long tradition of timid “deference,” it’s questionable whether the Roberts’ court, or any future court for that matter, would have the spine to overturn it or ignore it.

          http://www.weeklystandard.com/articles/case-against-deference_732052.html?nopager=1

      • RLC2

        Its already happening. Good older internist I saw 5 years ago converted his practice a couple months later to concierge membership only model. Smart man, ahead of the curve.

        • Corlyss

          I’m speculating here, but the Congress can outlaw that with in a single stroke. The government despises competition. Look how it has supplanted charities, and what was one of the principal trial balloons in the tax reform debate? Elimination of deductions for charitable contributions.

      • Rich K

        Doctors need to be licensed to practice and every State has rules that dictate how that happens so it no stretch to require they take Medicare patients or surrender that license. Scared Now?

        • Corlyss

          Correct me if I’m wrong, but didn’t some thing like that happen in Mass under Romneycare? The doctors fled in droves to other states. But once the feds adopt a similar draconian rule, American doctors may become one of our main exports.

    • Corlyss

      “I’m beginning to wonder if anybody did. . . ”

      Luke, how could you have ever doubted that no one in Congress knew what the heck they were doing after Pelosi told the world, “you have to read the law to know what’s in the bill”?

      “Medicare for all” at least has the advantage that it is easy to understand. ”

      IT’s also the single program that most endangers the US fiscal health in the future.

      “And if there were no other alternatives how could doctor’s possibly refuse to take Medicare patients?”

      There will always be alternatives. Private payment, like in the good ol’ days before 3rd party payers became the rule. Subscriptions as Mead has reported on several times here. Medical tourism. That’s just 3. There are probably more I didn’t think of.

    • Allan Theobald

      Medicare is broke with a 55 trillion dollar unfunded liability. Single payor will/would bankrupt the country completely as every business will be dumping all their costs on the government.

    • HSmith

      I hate to burst the Starwars universe you’re living in, but, doctors are already refusing Medicare patients. That is the reason I purchased a good secondary policy when I went on Medicare.

      • RLC2

        And you better get one while you can, before they become too expensive or against the law.

  • Corlyss

    All this erosion of support is just so much whining from many of the interests that made Obamacare happen. It amounts to sound and fury signifying nothing without action to gut or repeal it entirely.

  • Arch

    If anyone is curious about where we are going, read Cancer Ward, by Aleksandr Solzhenitsyn. It’s not a pleasant story.

  • WilliamK

    By law insurance companies are not allowed to warn their customers about coming changes in benefits and premiums that are due to ObamaCare. Of course, once ObamaCare is fully implemented the truth comes out.

  • West Texas Intermediate Crude

    Practicing physician here. Formerly private practice, now under contract with hospital.

    It’s possible to stay afloat with a 100% medicare practice, but only with assembly line volumes and practice patterns. Just don’t be too complicated, or you will become a cost center for the practice, and it will become inconvenient to keep you alive.

    At some point, we will have single payer coverage- it’s clear to me that the ACA is a stepping stone for this. Most likely the single payer will be an extension of medicare. Some docs are now limiting or refusing the # of medicare patients they see. At present that is legal in most states. It would be easy for the feds to pass a law, or more likely a regulation, that motivates each state to require every doc to accept medicare as a condition of receiving its share of fed dollars.

    Inevitable outcome of this is the medical profession becoming far less desirable to top students, and health care approximating USPS or DMV in quality of services available.

    Good.

    Fast.

    Cheap.

    Pick any two.

  • bittman

    Obamacare was passed using every kind of devious political means possible at a time when about 85% of Americans were satisfied with their healthcare. Big Corporations, hospitals, healthcare companies supported it because they thought the old-fashioned crony capitalism where big government rewards big entities at the expense of small business would prevail. The majority of Americans saw it what it was — Socialism. The HHS with all of its mandated coverages, scandals, and red tape is proving how incompetent big government bureaucrats really can be. The IRS by its abuse of power relative to Tea Party members has proven it cannot be trusted with Obamacare. And, now with Prism, we cannot trust bureaucrats with our medical records. Obamacare needs to go the way of Prohibition. It will be a disaster for America’s healthcare and for our Constitution.

  • RLC2

    Cloward – Piven.

  • RLC2

    Oh, and I will be sure to trust the IRS in administering this, too. Yep.

  • Rich K

    Luckily I’m too poor now to even worry about health care costs or even filing taxes so thanks for that Democrats.

  • swen13

    The new health insurance law created a new tax on every American. The law also created a new tax loophole/deduction for citizens to apply for on their yearly tax returns involving massive amounts of paper work and turning over all medical records to the IRS. Or on next years tax return where it asks do you have IRS approved insurance a citizen could check “NO” and pay the new fair share tax. Less paper work, smaller payment to the tax accountant, (most charge by the form), buy whatever type of insurance one wants or pay cash without any involvement with the IRS except to get a smaller tax refund.

  • xbox361

    The only joy in being a doctor next year will be telling an Obama supporter they are screwed because of Obamacare.
    Hope I don’t get in trouble for laughing in their faces, telling them that an illegal now is gets the care they would have.

    Hahahahahahahahahahhaha!