A Not-So-Happy Obamacare Anniversary

Justin Haskins Heartland Institute
Published March 23, 2016

Consumer Power Report #499

Six years ago, President Barack Obama signed into law the Affordable Care Act (ACA), radically transforming the U.S. health care system and insurance marketplace. Proponents of the ambitious legislation promised it would improve the quality of care for all Americans and provide access to health insurance for millions of people who couldn’t afford insurance but didn’t qualify for Medicaid. Proponents also said insurance companies would make billions of dollars in additional revenue from the expanded health insurance market, largely resulting from the individual mandate.

Sounds like a win-win-win scenario. What could possibly go wrong? A lot, apparently.

Since the ACA marketplaces opened in 2014, health insurance premiums have skyrocketed, high-quality health insurance policies have disappeared from Obamacare marketplaces across the country, and health insurance companies are losing millions of dollars (UnitedHealth lost nearly $475 million in 2015 alone.)

The Obama administration and congressional Democrats ignored the protests made by tens of millions of Americans, the recommendations of countless think tanks and policy experts, and pleas from pro-liberty elected officials in Washington, DC and in state governments across the United States. The results have been disastrous.

Making matters even worse, just one week before Obamacare’s anniversary, Edmund Haislmaier, a senior research fellow for the Center for Health Policy Studies at The Heritage Foundation, released a new Issue Brief revealing the number of “exchange-participating insurers” has significantly declined in state and federal exchanges, leaving consumers with fewer options from which to purchase quality health insurance.

According to Haislmaier, “[In 2016,] there are 287 exchange-participating insurers, as compared to 307 in 2015. While the participation level in 2016 is greater than the 253 insurers that offered exchange coverage in 2014, the figures for all three years are still well below the 395 insurers that offered individual-market coverage in the 50 states and the District of Columbia in 2013, just prior to the ACA taking effect.”

Haislmaier also says the number of “unique carriers” offering plans in one or more states has declined by 11 percent, from 155 in 2015 to 137 in 2016, leaving some consumers with very few health insurance options. In Alaska and Wyoming, only one insurer offers health insurance on an ACA exchange.

There’s no mystery to solve here. The reason Obamacare has failed is because certain ACA provisions, such as the requirement to cover pre-existing conditions, are pushing an increasingly larger number of uninsured, sick patients into the health insurance pool without incentivizing healthier people to join as well. ACA supporters believe this problem will be solved when the individual mandate penalty for not having insurance reaches a level that’s so high all people will essentially be forced to buy insurance, but Medicaid expansion, high levels of student loan debt, a sluggish economy, and high premiums could mean more young people and healthy middle-aged Americans enroll in Medicaid expansion, Obamacare alternatives, or less-expensive or catastrophic health insurance plans, rather than pay the higher premiums required by many of the higher-end Affordable Care Act health insurance policies, such as Silver Plans or Gold Plans.

According to the Centers for Medicare and Medicaid Services, Medicaid rolls expanded in states without Medicaid expansion by 10 percent since July–September 2013, but they expanded by 34 percent in states with Medicaid expansion over the same period. Since the end of 2013, the number of people enrolled in Medicaid has risen by 14 million.

Health insurance premiums continue to go up, access to quality care continues to fall, and insurance providers are pulling their ACA exchange offerings in significant numbers. Happy anniversary Obamacare, and thanks for nothing.

— Justin Haskins



When it comes to health care for veterans, the gap between Republican U.S. Sen. Ron Johnson and Democrat Russ Feingold goes deeper than a political blame game. …

Johnson, the first-term senator from Oshkosh [Wisconsin], favors partially privatizing veterans health care. Feingold, the three-term former senator from Middleton [Wisconsin], maintains the VA system should remain public but be better-funded.

Veterans health care has been under national scrutiny, following revelations that veterans across the country were waiting too long to get treatment — in some cases, dying while waiting for care.

Demand for veterans health care has soared in recent years as soldiers returned home from Iraq and Afghanistan, and as many Vietnam-era veterans reach an age where they need more care.

Johnson envisions a lesser role for VA staff and facilities to meet the growing challenge. In an interview, Johnson said he supports a system in which veterans would have more opportunities to choose between getting care from the VA or from private providers.

“The long-term solution would be to give vets more choice to access private health care,” Johnson said. …

Feingold told the State Journal that lawmakers need to provide the VA with adequate funding, particularly to improve mental health and women’s health services.

Feingold said Wisconsin veterans regularly tell him they don’t want their health care left in private hands.

“(Johnson) essentially says that he doesn’t think a public VA is ultimately the way to go, that it’s destined not to work because the government is involved,” Feingold said. “Well, that’s not what veterans tell me.

“They want it improved, but they would prefer the VA not be privatized–and I agree with them.”

Johnson said he does not support total privatization of veterans health care. VA facilities should retain key roles in caring for veterans, he said, by becoming hubs of treatment for ailments common to veterans such as amputations or post-traumatic stress disorder.

SOURCE: By Mark Sommerhauser, Wisconsin State Journal


Monday marks the start of the Idaho Legislature’s 11th and last week. At least everyone hopes it’s the last week. …

There is some heavy lifting yet to do on major legislation regarding health care for the uninsured and cuts to the income tax. …

Health care: A new bill dealing with health coverage for 78,000 lower-income Idahoans without insurance was scheduled for Monday morning in the House Health & Welfare Committee. But Sunday, committee members were notified the bill’s language was still being revised and the meeting was delayed until possibly Tuesday.

The proposal was expected to be a work in progress through the weekend, and its details – and the timing of the hearing – were open to change. House Speaker Scott Bedke noted the challenges of getting something on health care done while speaking to the Spokesman-Review this weekend: “Personally I’m growing frustrated, but there’s still, obviously enough, there’s willingness to do something. They just can’t come together. I’m not very optimistic at this point.”

There’s a lot of anxious expectation surrounding the new proposal. It’s got support from some leaders and the committee’s advocates for expanded health care, but it butts up against the Republican Legislature’s genetic antipathy for federal mandates and its deep dislike of Obamacare. If it doesn’t fly, it’s a certainty that for all the talk about having to help the “gap group” this year, nothing will get done. There will be hand-wringing, blame-assigning and perhaps some general gnashing of teeth. But it’s not an issue likely to keep lawmakers in Boise another week.

It’s expected to move through committee. After it does, it will see expedited action on the House floor. Where it goes from there is too chancy to predict.

SOURCE: By Bill Dentzer, Idaho Statesman


A report from the Ponemon Institute finds the average healthcare organization has battled at least one cyber-attack per month over the last year. Fierce Health IT reports 48 percent of organizations surveyed said their organization had a breach involving loss or exposure of patient information during the same time-frame.

“The concurrence of technology advances and delays in technology updates creates a perfect storm for healthcare IT security,” said Stephen Cobb, senior security researcher at ESET in a news release. “The healthcare sector needs to organize incident response processes at the same level as cyber criminals to properly protect health data relative to current and future threat levels. A good start would be for all organizations to put incident response processes in place, including comprehensive backup and disaster recovery mechanisms. Beyond that, there is clearly a need for effective DDoS and malware protection, strong authentication, encryption and patch management.”

Despite obvious concerns about the security of mobile health, only 27 percent of respondents said their organization includes medical devices in its cybersecurity strategy. Even more startling, only 33 percent of respondents rate their organization’s cybersecurity posture as very effective.

SOURCE: By Katie Wike, Health IT Outcomes


The Centers for Medicare and Medicaid Services was “passive” in its approach to identifying and preventing fraud in administering Obamacare, according to testimony from the Government Accountability Office.

According to the report, the agency must verify an individual’s application information to determine he or she is eligible for health care coverage. The individual must be lawfully present in the United States and may not be incarcerated unless they are awaiting a disposition of charges.

The agency detects application “inconsistencies” when an individual’s personal information is not correctly matched against the data from other federal agencies such as the IRS, the Social Security Administration, and the Department of Homeland Security.

“[The Centers for Medicare and Medicaid] did not terminate or adjust subsidies for any applications with incarceration or Social Security number inconsistencies,” the audit states. “[Agency] officials told us that they currently do not plan to take any actions on individuals with unresolved Social Security number or incarceration inconsistencies.”

The investigators found that for coverage year 2014 the agency did not resolve about one-third of applications with inconsistencies, which involved $1.7 billion in associated subsidies.

“We concluded [the agency] has assumed a passive approach to identifying and preventing fraud, and that adopting a more strategic, risk-based approach could help identify fraud vulnerabilities before they could be exploited in the enrollment process,” the audit said.

SOURCE: By Ali Meyer, Washington Free Beacon