The Obamacare Debacle

November 15, 2012 • Commentary
This article appeared on National Review (Online) on November 15, 2012.

If one wanted to sum up the consequences of the entire 2012 election in a single issue, look no farther than Obamacare.

The new health‐​care law is generally regarded as the signature achievement of the president’s first term. It’s certainly emblematic of Obama’s entire approach to government and what we can expect from his second‐​term initiatives.

The president promised a great deal of benefits from health‐​care reform: lower premiums, better care, universal coverage. He reassured Americans: If you had health insurance, and you liked it, you could keep it. The bill’s gross ten‐​year cost would be less than $1 trillion, and the legislation would actually reduce the deficit in the long run. The rich and some big businesses might have to pay a bit more in taxes, but the middle class would be better off.

But as with so many other policies of this administration, the results never matched the rhetoric. The pretty promises turned out to be “just words.”

Rather than work across the aisle, President Obama pushed his bill through on a purely partisan basis, using dubious parliamentary maneuvers and refusing to consider Republican alternatives. Nor was the president deterred by public opinion. Polls consistently showed that Americans opposed the president’s plan — they still do — but the president insisted on doing it his way.

The president who always prefers government to markets unsurprisingly produced a costly new entitlement program, financed by both new taxes and massive debt, that relies on top‐​down planning. The $1 trillion price tag has been left far behind. The Congressional Budget Office estimates that the bill will now cost at least $1.8 trillion through 2022, and other estimates suggest it could cost as much as $2.2 trillion over that period if all costs are taken into account, adding more than $823 billion to the deficit over ten years.

Even the government’s own actuaries expect it to drive up insurance premiums. The most recent report by the Department of Health and Human Services estimates that in the future premiums will rise at 7.9 percent annually, double the rate they would have risen if Obamacare had not been passed.

Many of Obamacare’s taxes fall not just on the rich, but on the middle class and small businesses. In fact, the mandate “tax” in particular will hit 11 million middle‐​class taxpayers to the tune of $6 billion. Moreover, the law’s costly new mandates and regulations are widely seen as a small‐​business job killer.

And, while Obamacare doesn’t directly ration care, it puts in place structures that will almost inevitably lead to rationing. Notably, beginning in 2017, a board of 15 unelected bureaucrats, the Independent Payment Advisory Board (IPAB), will have the authority to impose drastic cuts to physician reimbursements under Medicare. If abused, this authority could allow the government to refuse to pay for some treatments or providers, effectively rationing care. Even under the best of scenarios, the already‐​planned cuts will force as many as 15 percent of hospitals to close and cause many doctors to stop seeing Medicare patients. Given Medicare’s enormous unfunded liabilities, some reduction in benefits is inevitable, but it is typical of the Obama administration to prefer that bureaucrats rather than individual consumers decide how that reduction takes place.

In addition, millions of Americans are discovering that they will not be able to keep their current health‐​care plans. This includes seniors who will lose their Medicare Advantage plans, and businesses and individuals who find their plans non‐​compliant with Obamacare’s required benefits (such as Catholic charities and schools that are now required to offer birth control, including abortifacients). Surveys suggest that 10 to 30 percent of employers could drop their coverage, dumping their workers into plans offered on the government‐​run exchanges.

Yet, for all this, Obamacare falls far short of its goal of universal coverage. Nearly 20 million Americans will still be uninsured after the bill is fully implemented. Millions more will simply be dumped into Medicaid.

A President Romney could have used waivers, executive orders, and his power over budgets to delay or cut back on parts of the law.

Thus, on health care, as on so many other issues, last Tuesday’s election left us with a president whose belief in big government and centralized control has been and will only continue to be a disaster. The 2012 election has delivered us a devil we know all too well.

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