ACA defenders boast that these premium increases are largely irrelevant, because 85% of consumers on the exchanges receive subsidies to defray the costs. But this statistic paints an incomplete picture. A family of four that makes more than $100,000 a year is deemed too wealthy, and receives no subsidies. This family will likely be unable to afford any policy on the ACA exchanges, so instead will buy a policy off the exchange. By one estimate, nearly half of the consumers on the individual market receive zero subsidies. Minnesota Gov. Mark Dayton was correct in calling the Affordable Care Act “no longer affordable” for an increasingly large share of Americans.
President Obama also shirked any responsibility for those who lost the doctors they liked because their “networks have changed.” The networks of covered doctors, he insisted, are “not determined by the Affordable Care Act,” but by the insurers. This explanation is disingenuous. One of the pillars of the ACA is to push consumers into plans with smaller networks to control costs. People cannot keep the doctor they like if it is not cost effective—contrary to the President’s oft‐repeated promise. Shrinking networks and consolidating care is a feature, not a bug of ObamaCare.
President Obama also dismissed the cause of spiraling copayments. “It’s not because of ObamaCare,” he claimed. Rather, “these are decisions that are made by your employers.” This response obfuscates the reality of health care economics. The ACA’s onerous and costly mandates have made health insurance more expensive. To avoid sticker shock, insurers have masked premium increased with ballooning copayments—customers now need to pay more out of pocket before receiving any benefits under ObamaCare. All of these changes were entirely foreseeable consequences of a law designed to control costs and ration care. Critically, shrinking networks and increasing copayments are not offset by subsidies.
As President Obama continues to dictate what his legacy should be, he remains in a state of surreality: he proudly takes credit for all of the people helped by the Affordable Care Act, but steadfastly blames everyone else when things go wrong. “If your premium is going up, it’s not because of ObamaCare,” he said. “It’s because of your employer or your insurer … It’s not because of any policy of the Affordable Care Act that the rates are going up.” The President is still in denial that his signature law is unraveling our health care marketplace. The fault, dear Barack, is not in our stars, but in ourselves.