First, untold millions will "lose" health insurance: The NEWLY insured population has never been credibly tallied. Obamacare, the Affordable Care Act includes enrollees in expanded Medicaid and enrollment in exchange plans. However, in terms of "newly" insured, there is no number. The 18 million or 20 million number thrown about includes individuals who had insurance plans that disappeared under Obamacare and who were forced to purchase plans elsewhere. It includes individuals who were eligible for health insurance but didn't purchase it until Obamacare made it illegal, a finable penalty not to purchase health insurance. It didn't account for the newly UNINSURED people, including the millions of people who could no longer afford health insurance for their dependents under their employer offered plans and who were ineligible for exchange plans because their employer offered them self-only health insurance (the family glitch). Further, even Obamacare's annual enrollment figures dropped by millions each year as declared numbers were revised to more closely reflect reality.
What we can safely say is that there are more people who have health insurance as a result of Obamacare's three provisions: First, penalties were attached to not purchasing health insurance, second, Medicaid expansion made new people eligible for no-cost health insurance, and third, although some states already had the provision, the nationalization of making it possible for parents to have their grown children on their plans until those children turned 26 did encourage more parents to purchase health insurance for their children. But we don't know how many people "gained" health insurance under Obamacare or are "newly" insured.
Second, stop blaming President Obama, it's not his fault: Many people balk at any criticism of President Obama when it comes to the Affordable Care Act. Sure, there's plenty of blame to go around to Congress and state representatives as well, but let's face it, when you've got a law that's nicknamed after you and you endorse nickname, as President Obama did, it's tough to pretend the former President was not responsible for the law.
This blame is more appropriate still because Obama himself was so publicly untruthful about the law from describing exchanges as "group" insurance, to talking about a "single risk" pool, to even trying to float the lie that the US had universal health coverage and naturally, the now familiar lies of families saving $2,500 a year, insurance like his family, and keeping doctors if you want them.
Third, worrying about the insurance companies: There's lots of misplaced empathy for insurance companies, with even Republicans worrying about "stabilizing" them. It's bizarre. Neither providers nor insurance companies are victims. Obamacare was worried about insurance companies PARTICIPATING in its exchange scheme, that's why the Affordable Care Act included reinsurance, risk corridors and risk adjustment.
When it came to the 2016 and beyond departure of plans leaving exchanges and upping their premiums, this too was part of the original law which provided that the government payments to insurers via reinsurance and risk adjustment were designed to be TEMPORARY, in the law itself expiring for the 2017 benefits year.
Further, the increase in premiums was predicted by the Congressional Budget Office under Obama, "Reinsurance payments that the government makes to insurance plans whose enrollees incur particularly high costs for medical care will be phased out over the next two years, placing upward pressure on exchange premiums…" (CBO, Pub. 49973, page 22).
The Obamacare model in fact depended on paying off insurance companies to participate and set up the foreseeable departure of insurance companies from exchanges and the increase in premiums charged on exchanges because those payoff provisions were TEMPORARY.
Fourth, premium increases are not Obamacare's fault: Of course they are. Obamacare set up the opportunity for enormous increases in premiums charged to exchange members because the prices of plans on exchanges were directly connected to the costs of the second lowest priced silver plan available in a specific region and the costs of these plans have soared.
According to Kaiser Family Foundation, as of September 14, 2016, before President Trump, workers, not just those individuals on exchanges receiving Obamacare entitlement payments, but workers paying for employer provided benefits have paid 28 percent more in premiums since 2011.
For Obamacare, this means that if you live in an area where those not on exchanges are paying a fortune for their premiums, your premiums under the law would also go up. Therefore, every year the federal government's payments for premium assistance and cost sharing for working Americans on Obamacare plans would also increase. Because the federal government picked up increases for exchange enrollees, not workers, their increases were disguised. Under Obamacare there was never any intention of curbing how much more could be charged each year by insurers.
Conclusions (Opinion):
First, I don't agree with forcing people to purchase the consumer product of health insurance because it is a consumer product and by forcing us to purchase it we have disincentivized insurers from responding to what consumers need and changing and improving their product. Instead, Obamacare strengthened insurance company strangleholds on Americans by penalizing us for not purchasing a consumer financial product, taking away one of the persistently strongest consumer powers in our country, voting with our dollars and our feet.
Also, the idea, put forth by insurers and adopted by government of forcing people to purchase health insurance didn't satisfy insurance companies, they still complained they didn't have enough enrollees in specific plans, forcing them to incur costs of sicker populations.
Second, as far as "blaming" President Obama, substitute in some euphemism, credit Obama with the failure of the Affordable Care Act. Certainly, the President took an active role in "selling" the law using falsehoods and lectures and any other tool available to him. But you can't blame where we are on a President who had NO connection to the enactment of the law, it's not credible.
Third, insurance companies are not victims. If they object to the prices they pay on behalf of individuals who purchase their products, they should negotiate with providers. Consumer relationships with insurance companies are ALWAYS adversarial, they want to charge more and pay out less, that's profit to them, consumers want to have more coverage and pay less.
Given that tension, the importance of genuine group plans emerges, the tradeoff by employers, unions or other organizations of the promise of more customers for what amounts to a group discount, just like any other group discount. Obamacare in spite of the President's repeated error in calling exchanges group coverage was NEVER group coverage and in fact Obamacare significantly weakened the concept of group coverage because all working Americans were forced to purchase a product. The group was defined by law so the model of a group discount was erased.
Finally and fourth, it doesn't make sense to blame President Trump for the intended and foreseeable and realized consequences of Obamacare. Let's say you're worried about working Americans who won't get government subsidies to pay for their health insurance if Obamacare is repealed. I'd argue that the dramatic increase in costs imposed on the rest of the workers should have caught your attention and sympathy a lot sooner than the threat of ending an entitlement payment to the far smaller number of working Americans getting deals on exchanges.
Remember, that's been going on to the tune of a 28 percent increase from 2011 to 2016 for your fellow working Americans under Obamacare who aren't on exchanges. For "Covered workers average dollar contribution to family coverage has increased 78% since 2006 (Exhibit D) and 28% since 2011 (data not shown)." (Kaiser Family Foundation, http://www.kff.org/report-section/ehbs-2016-summary-of-findings/).
Regardless of your terminology, the sad fact is that health insurance remains too expensive for many of us and is becoming too expensive for many more of us. Addressing costs via Obamacare methods is not the answer because the government partnership with insurers focused on getting everyone "some" policy which changed the goal of insurance from providing a consumer product that protects consumers from financial ruin in the event of needed medical services to the goal of forcing everyone have the consumer product of health insurance with devastating inattention to what that consumer product provides to consumers.
If you have health insurance that doesn't assist you in obtaining needed medical services in a timely fashion and paying for those services, then as the product of health insurance it fails. That's where we are and that's where our attention should be.
