Despite the best-laid plans of our central planners, Obamacare is unraveling. In 2009, the Obama administration proposed an ambitious bill that aimed to seamlessly expand health insurance for millions of Americans. The uninsurable would be guaranteed access to insurance. The insured would keep the plans they liked. The uninsured would be penalized. Profitable insurers would transfer their gains to unprofitable competitors. Online exchanges — the mechanism to hold these mandates together — would allow customers to choose from a wide range of subsidized insurance policies. Or at least that was the plan.
We are only three years into this bold, persistent experiment, and virtually all of the experts’ forecasts have already been proven wrong. The carefully crafted measures designed to stabilize the markets have faltered. The uninsurable are using coverage that is far more expensive than anticipated. The insured lost the plans they liked and are now confronting skyrocketing premiums and dwindling choices. The uninsured are not signing up, leaving risk pools skewed toward older and sicker customers. Insurers are suffering far greater losses than expected and are rapidly fleeing the exchanges. As I discuss in my new book, Unraveled: Obamacare, Religious Liberty, and Executive Power, these failings are the entirely foreseeable consequences of the law’s fractious birth, illegal implementation, and arrogant central planning. A careful study of Obamacare’s history leads to a bleak forecast of the law’s uncertain future.
And from the conclusion:
The next president will face a stark political reality: Half the country hates Obamacare and wants no part of it; the other half thinks that Obamacare didn’t go far enough and now wants single-payer coverage. Efforts to reform the law will have to consider that roughly 14 million people now rely on Obamacare’s expanded Medicaid coverage and about 10 million people have purchased subsidized insurance on the ACA exchanges. These facts make the “repeal and replace” mantra almost impossible to fulfill. But we should not lose sight of the tens of millions of Americans who were harmed by the ACA: those whose plans were canceled or who saw premiums increase, deductibles skyrocket, networks shrink, or their choice of policies decline to one.
I am not sanguine about the opportunity for reform. The haughty decision to transform almost 20 percent of the American economy without any bipartisan buy-in, with the expectation that the law’s opponents would simply fall in line, has poisoned the well for future health-care reform. The ACA will no doubt muddle along for the next few years, until premiums grow so high that the consensus builds for a public option. But we should not be confident that this centralization will work any better than the last one. The same planners who assured us that the ACA could operate without a public option cannot be trusted to reform our health-care markets with a public option. Soon enough, Obamacare will unravel and collapse under its own weight. At that point, we will be on the road to single-payer.