Like most federal laws, ObamaCare promises a lot. The Affordable Care Act is seen as a great way to provide low cost health insurance to millions of people. But history has demonstrated that federal government programs never remain cost-effective over time. Look at welfare, Social Security, Medicare and Medicaid and you see cost overruns. Even the Post Office is swamped in a sea of red ink.
There are many reasons why the promises don’t match reality. Laws have all kinds of regulations and need bureaucracies to implement them. Bureaucracies tend to become rigid and mechanical in their implementation of laws because they must translate the legislation into practice. This often leads to court cases over what is written in the law and what is the law’s intent. It comes down to the fact that legislation tends to be misunderstood and quite often has unintended consequences. As Supreme Court Justice Scalia observed, “It is the law that governs, not the intent of the lawgiver. Men may intend what they will; but it is only the laws that they enact which bind us.” Since ObamaCare has over 1,500 pages of regulations that very, very few understand, Scalia’s statement is a prophecy that reality will not match intent.
A case in point is a gap in Medicaid. According to Politico, there is a gap in coverage between people who are too poor to qualify for federal subsidies on the exchanges but not poor enough to get Medicaid in some states.
Even former Democratic President Clinton warned that the Affordable Care Act may NOT be so affordable. He pointed out that some companies provide health insurance just for their employees and not their families. But the law requires all individuals to have health insurance. Families, especially those of low wage earners, will be faced with either buying the health insurance for each family member through the exchanges or paying the penalty for each family member not covered by health insurance. This could lead to millions NOT being covered by health insurance.
Those who are idealistically enough to believe Obama’s promises are in for a nasty surprise. First, cost projections even by the non-partisan Congressional Budget Office demonstrate that over time cost will rise. This is why the Obama Administration did what is called “front loading” ObamaCare. “Front loading” is when you start to collect money in advance of implementing a law. Obama took $780 million out of Medicare as a down payment on ObamaCare. Second, the administration of the program will require more bureaucrats to enforce the requirements of the law. This, of course, will require more money to hire the bureaucrats. Third, the ten essentials mandated for all health insurance policies will mean insurance companies will have to pay more money to doctors and hospitals because of the expanded coverage. This exponentially increases expenditures and will require higher, not lower, premiums to cover the additional costs.
In short, the rich don’t have a problem because they can pay for expensive health insurance policies. It is the poor and the middle class who will be negatively impacted by the Affordable Care Act. What is forgotten in all of the ranting of the politicians is that our economy is not strong and millions are out of work or receiving welfare. As long as Obamanomics doesn’t fix the economy and drive up employment numbers, ObamaCare is doomed to failure.