Repeal and Replace

On this first anniversary of the president signing the health reform bill into law, Investor’s Business Daily features an editorial I wrote with Newt Gingrich and Jim C. Capretta. It reflects our one-year assessment of ObamaCare that we presented to the National Press Club last week:

  • Ever-More-Costly Mandate: ObamaCare will force Americans to buy insurance whose premiums will rise at twice the rate of their incomes.
  • Bizarre System of Subsidies: Depending on where insurance is bought, the subsidies for individuals are radically different, a cost factor so large it will force a major reorganization of American business.
  • Perverse Incentives for Insurers: Health plans will try to attract the healthy and avoid the sick; and after enrollment, they will over-provide to the healthy and under-provide to the sick.
  • Perverse Incentives for People Buying Insurance: With small (and maybe unenforced fines), people will have an incentive to wait until they are sick to buy insurance, and then drop coverage after their medical bills are paid.
  • Tattered Safety Net: With 32 million newly insured and more generous coverage for almost everyone else, there will be a huge increase in the demand for care; but the legislation has no provisions to increase supply. The result: increased waiting times at the emergency rooms and in doctors’ offices — with those whose plans pay below market being pushed to the rear of the waiting lines.
  • Benefits Cuts for Seniors: Deep Medicare cuts will make it increasingly hard for seniors to find doctors to treat them and facilities who will admit them.

These problems and the recommended solutions build on a continuing consensus among critics about what the problems are and how to solve them — beginning with an editorial Newt and I wrote for The Wall Street Journal last year and a Capitol Hill think tank briefing in January with the Heritage Foundation, the American Enterprise Institute, the Cato Institute and the American Action Forum — featuring this summary document.

Comments (7)

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  1. Paul H. says:

    I think you’ve nailed them.

  2. Devon Herrick says:

    The list is on target. The Affordable Care Act will not slow spending. The insurance reforms will cause people to game the system, which will destabilize the individual market risk pools. The exchange subsidies will segment employers into entities that can take advantage of the subsidies.

    We are destined to revisit this issue in the coming years if reforms are not done.

  3. Greg says:

    Good analysis.

  4. Erik says:

    We should replace Obamacare with the 1993 Republican Health Care Reform proposal. It is a much better, well thought out proposal.

  5. Amanda M. says:

    Nice evaluation.

  6. Virginia says:

    I had no idea it had already been a year! Let me guess: the NCPA staffers declined to celebrate this monumental day?

  7. Mike Crimmings says:

    Looks like it was meant to fail so we’d all fall into a government single payor system known as socialized medicine. What happens when the one-year waivers run out for all the big companies that received them?