Policy Analysis No. 745

Obamacare: What We Know Now

For all intents and purposes, the Patient Protection and Affordable Care Act (ACA), also known as Obamacare, has been fully implemented. And while much of the media coverage has been dominated by the technical failures of the program’s initial rollout, we are also learning much about the impact of health care reform on employers, providers, patients, taxpayers, and individual consumers. Much of this was suspected even before the law was passed, but it is now becoming clear as implementation moves forward.

For example:

  • Millions of Americans who are happy with their current health insurance will not be able to keep it;
  • Americans may find it difficult to keep their current doctor unless they are willing to pay more;
  • While there will be both winners and losers when it comes to the cost of insurance, millions of Americans will find themselves paying higher premiums or facing higher out-of-pocket expenses;
  • The law’s final cost is difficult to predict, but is likely to exceed early projections;
  • Far fewer Americans will be covered than expected, leaving millions still uninsured;
  • The law is already having serious economic consequences and will likely lead to a loss of jobs and slower economic growth; and
  • There is a significant danger that young and healthy people will not enroll, leading to an “adverse selection death spiral.”

In short, the more we have learned about ACA, the more it looks like its critics were right. The law’s problems go far beyond a failed website. By imposing a bureaucratic, centralized, top-down approach to health care reform, Obamacare has created far more problems than it solved.

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Michael Tanner is a senior fellow with the Cato Institute and author of The Poverty of Welfare: Helping Others in Civil Society (2003).