In advance of our event at the National Constitution Center on Monday evening, the Philadelphia Inquirer published my editorial about the Affordable Care Act. My proposed title was “Obamacare Was Unraveling Before President Trump Took Office.” The Inquirer chose “Obamacare is unlikely to survive even if it is repaired.” It works.
Here is a snippet:
During his first address to Congress, President Trump urged the legislative branch to “save Americans from this imploding Obamacare disaster.” Steve Beshear, the former governor of Kentucky, dismissed this charge in the Democratic response but admitted that the law will “need some repairs.”
Neither was correct. Though not quite a “disaster,” yet, the law needs far more than mere repairs.
After nearly eight years of attacks from every conceivable direction, the Affordable Care Act is still standing, and millions of Americans now rely on its expanded coverage. Though the law itself has survived, we must be frank about both its significant benefits as well as its precarious future. Even before the 45th president was sworn in, the health-care reform had already begun to unravel.
Even if Republicans did nothing, and stood idly by, ultimately, the number of insured Americans would fall in light of higher premiums, fewer options, and contracted coverage. Insurance simply becomes a less worthwhile investment for more Americans. After only three years, the ACA’s intricate planning – designed to ensure the viability of the health markets – has already proven unsustainable.
Economist Herbert Stein’s rule applies forcefully to the ACA: “If something cannot go on forever, it will stop.” Regardless of whether the Affordable Care Act is repealed, replaced, repaired, or left in its current form, the law could not survive through the next election.