The three faces of ObamaCare
Byron York writes at the Washington Examiner of ObamaCare’s three faces, citing figures from the L.A. Times:
The Times says the numbers break down like this: 4.5 million previously uninsured people are now on Medicaid; 3 million previously uninsured young people are now covered because of a provision that allows them to stay on their parents’ policies until age 26; and 2 million previously uninsured people have purchased coverage on the Obamacare exchanges. In all, it is “the largest expansion in health coverage in America in half a century,” according to the Times.
Assume all the numbers are correct, or at least close to correct. By far the largest part of Obamacare’s health coverage expansion has come from a) expanding Medicaid, and b) allowing young people to stay on their parents’ coverage. The part where Democrats essentially blew up the health care markets, imposed the individual mandate, and caused premiums to rise and deductibles to skyrocket? That hasn’t been such a success. If the Times number are correct, all of that — placing new burdens of higher costs and narrower choices on millions of Americans, in addition to setting the stage for coming changes in employer-based coverage — has resulted in two million of the previously uninsured gaining coverage.
So the face with the black eye and missing teeth – the part of ObamaCare that obviously doesn’t work – is the one President Obama was smooching on the forehead in his April Fool’s Day “victory lap.” Trillions spent, endless hours of Americans’ time wasted, hundreds of thousands of jobs destroyed, and the Constitution rewritten…. all to get maybe a million formerly uninsured people signed up for ObamaCare, and the actual number as of March 31 will probably turn out to be closer to half a million, once the unpaid and invalid “enrollments” are sorted out. (The formerly uninsured have an exceptionally high rate of non-payment.)
It’s no surprise that President Obama didn’t limit the discussion to the formerly uninsured when he was patting himself on the back yesterday (easy to do when his Affordable Care Act enrollment was entirely symbolic, and completed by a horde of minions at that, so he didn’t even have to waste his time with the crap website he foisted on you. The rest of us must be careful about back-patting, because we don’t want to injure ourselves, and learn about those high ObamaCare out-of-pocket costs the hard way.) If he invited the media to join him in celebrating the sale of less than a million insurance policies at gunpoint, with a trillion dollars in spending, even the most energetic lapdogs might have stopped wagging their tails.
But it’s interesting that he didn’t have much to say about the L.A. Times’ total of 9.5 million covered, which would leave 3.5 million net, after backing out the 6 million victims of Obama’s Big Lie. (As those people learned to their sorrow, if you like your plan, you can’t keep your plan; ditto for your doctor.) In the darkest days of the HealthCareDotGov launch debacle, the Administration’s phony enrollment numbers did include Medicaid referrals. It’s one of the few deceptions the supportive mainstream media has ever called them out for. They did it very gently, of course – not by confronting Administration flacks and telling them it was supremely dishonest to lump a welfare program in with the sale of insurance policies, but through a growing tendency to quietly note that the latest made-up figure from Health and Human Services included Medicaid numbers.
Part of the Administration’s growing reluctance to discuss Medicaid might therefore stem from their awareness that the talking point has grown stale. They don’t want the public to dwell on what Medicaid is, how poorly it performs, or how much it’s costing taxpayers. As that cost balloons, mixing Medicaid referrals in with ObamaCare insurance policy sales would make the balance sheet explode with a severed-artery spray of red ink.
Another good reason to stop talking about these other two faces of ObamaCare is that neither of them is really part of the program, but their results absolutely dwarf the number of new insurance policies sold. The titanic expense and inconvenience of what most people think of as “ObamaCare” reeled in 800,000 or so of the uninsured, while 4.5 million of them went on welfare, and 3 million got covered under Mom’s increasingly expensive policy? That would be hideously embarrassing, if the media invited Americans to dwell on it.
And as Byron York observes, it means most of this suffering and wasted money was completely unnecessary:
The bottom line is that Democrats could have enacted two relatively small changes (small relative to the entirety of Obamacare, that is) in the health care system and achieved most of what Obamacare has achieved so far. Would Republicans have supported such changes back in 2009 and 2010? Who knows? Maybe a few would have — certainly the until-26 change — but the point is in the brief period when Obamacare was enacted, Democrats had about 255 votes in the Houseand 60 in the Senate. They could do what they wanted, which included pursuing more modest reforms that would have helped millions. Or they could blow things up and impose burdens on millions even as they helped others. Acting on decades of pent-up demand to take control of the health care system, they chose to blow things up. And that is the context for today’s new numbers
This also means the parts of ObamaCare that everyone hates – the junk Republicans want to repeal – can be disposed of without much inconvenience to the public. Heck, a lot of them are already keeping their old plans on temporary extensions granted by King Barack I, in a desperate bid to stave off widespread outrage until after the midterm elections. People would dance in the streets if they were told ObamaCare was gone, and they really could keep their plan if they liked it, forever.
Liberals wrote some smug op-eds yesterday, claiming that the real significance of the enrollment “milestone” was that millions of people are now helplessly dependent on the new Big Government boondoggle, so no matter how badly it fails, it’s not going anywhere, ever. That case is more difficult to make when the Left only has 800,000 hostages, and a replacement proposal can easily make allowances for them.
The Medicaid expansion will mean big trouble down the road – when state co-payments kick in a few years from now, it’s going to become a front-page crisis – and the American people deserved an honest discussion and vote, rather than dead-of-night social engineering as part of a bill the size of a telephone book. The business of classifying 26-year-olds as children is likely to cause problems over the long term as well, because it takes so many healthy young people out of the risk pool. But we can leave those for another day, and at least neutralize the expensive toxins Democrats are using to poison private health insurance, so they can build single-payer socialized medicine from its corpse.
Most Americans were actually satisfied with the insurance system before ObamaCare came along – that’s why Obama had to lie to them in 2009 about being able to keep their plans. The political energy to seize control of the industry was cultivated over the course of many years, by focusing on the discontented. It didn’t matter if 70 percent were happy, as long as 5 percent were not. That strategy is equally valid with respect to ObamaCare repeal, especially since the discontented were doing just fine before the Affordable Care Act came along – they were “working hard and playing by the rules” when they were suddenly found guilty of the “crime” of having low insurance premiums and good doctors.
Perhaps the end result will be portrayed as “reform” more than “repeal,” to give Democrats some political cover. Then again, King Barack has already repealed a good deal of his “signature achievement” by fiat. Whatever it’s called, the American people deserve an honest accounting of ObamaCare’s failures, and the opportunity to move into a more sustainable system that can start winning people back from Medicaid dependency… not arrogant lectures from the President about how Americans aren’t allowed to vote on these issues any more, or even discuss them, because we’ll never again be as free as we were in 2009.