Brian4Liberty
10-07-2016, 10:38 AM
Obamacare was built to fail (http://www.vox.com/the-big-idea/2016/10/7/13191250/obamacare-exchanges-crisis-arrogant-progressives)
The "exchanges" were designed by people with no understanding of markets.
By Avik Roy - Oct 7, 2016
...
On March 23, 2010, President Barack Obama signed the Affordable Care Act into law. It was a triumphant moment for the progressive movement, a moment in which the century-long quest for universal coverage in America passed an important landmark — and seemed headed for the final goal. "A big fucking deal," as Joe Biden famously summarized it.
Six and a half years later, health reform no longer feels like a steady forward march toward progress. It feels more like World War I: dotted with landmines, lined with trenches, and ending inconclusively. In 2010, the Congressional Budget Office predicted that 21 million people would be enrolled in the ACA’s insurance exchanges by 2016; as of now, only 12 million are. That gap between hype and reality is likely to further expand over time.
What happened? It’s a long story, of course. But the simple answer is that the ACA’s exchanges were designed poorly and implemented poorly, by overconfident advocates who dismissed any and all criticism, no matter how well-reasoned.
Left-leaning health-policy bloggers played a key role in the debate. Three weeks after that 2010 signing ceremony, veteran health care journalist Jonathan Cohn closed down his blog at the New Republic, "The Treatment." Its purpose — the passage of the ACA — had been achieved. Cohn’s valedictory post centered on a key episode that took place as the bill that would become the ACA was being debated in the Senate Finance Committee.
The left shot down reasonable criticism
In October 2009, analysts at PricewaterhouseCoopers published a report estimating that by 2016, the Senate Finance Committee bill would increase individual-market health insurance premiums by 47 percent. Today, we would describe that figure as a lowball estimate. In fact, cumulatively, median premiums for "silver plans" have nearly doubled in the ACA’s first four plan years (49 percent in 2014, 7 percent in 2015, 11 percent in 2016, and a projected 10 percent in 2017).
But in 2009, the ACA’s cheerleaders described it in much different terms.
...
But as a matter of policy, PwC was right and the cheerleaders and Democratic policymakers were wrong. The ACA’s exchanges were designed poorly, and premiums did become unaffordable for millions.
...
As Bill Clinton put it, "You’ve got this crazy system where … people that are out there busting it —sometimes 60 hours a week — wind up with their premiums doubled and their coverage cut in half." That’s why ACA exchange enrollment has fallen 9 million short of initial estimates.
The people who implemented the markets were ignorant and arrogant, too
And Obamacare didn’t suffer only from a flawed blueprint. It was also implemented by people with poor knowledge of how health insurance markets worked.
...
As those higher premiums started to become public, ACA cheerleaders engaged in another round of shoot-the-messenger, hoping that ignoring rate shock would make it go away. That didn’t work either. Instead, policymakers came upon the "solution" of simply rejecting insurers’ proposed rate increases, and forcing them to lose money. Insurers, having exhausted their options to participate in the exchanges and remain solvent, began heading for the exits.
A "public option" would only add to the problems
...
Instead of reconsidering the ACA’s thicket of costly and contradictory regulations, the law’s cheerleaders remain romantically attached to the unlikely notion that a "public option" could lower premiums — unlikely because it would only succeed if the government-run insurer paid doctors and hospitals far less than private insurers do, and forced providers to accept those lower rates.
...
More: http://www.vox.com/the-big-idea/2016/10/7/13191250/obamacare-exchanges-crisis-arrogant-progressives
The "exchanges" were designed by people with no understanding of markets.
By Avik Roy - Oct 7, 2016
...
On March 23, 2010, President Barack Obama signed the Affordable Care Act into law. It was a triumphant moment for the progressive movement, a moment in which the century-long quest for universal coverage in America passed an important landmark — and seemed headed for the final goal. "A big fucking deal," as Joe Biden famously summarized it.
Six and a half years later, health reform no longer feels like a steady forward march toward progress. It feels more like World War I: dotted with landmines, lined with trenches, and ending inconclusively. In 2010, the Congressional Budget Office predicted that 21 million people would be enrolled in the ACA’s insurance exchanges by 2016; as of now, only 12 million are. That gap between hype and reality is likely to further expand over time.
What happened? It’s a long story, of course. But the simple answer is that the ACA’s exchanges were designed poorly and implemented poorly, by overconfident advocates who dismissed any and all criticism, no matter how well-reasoned.
Left-leaning health-policy bloggers played a key role in the debate. Three weeks after that 2010 signing ceremony, veteran health care journalist Jonathan Cohn closed down his blog at the New Republic, "The Treatment." Its purpose — the passage of the ACA — had been achieved. Cohn’s valedictory post centered on a key episode that took place as the bill that would become the ACA was being debated in the Senate Finance Committee.
The left shot down reasonable criticism
In October 2009, analysts at PricewaterhouseCoopers published a report estimating that by 2016, the Senate Finance Committee bill would increase individual-market health insurance premiums by 47 percent. Today, we would describe that figure as a lowball estimate. In fact, cumulatively, median premiums for "silver plans" have nearly doubled in the ACA’s first four plan years (49 percent in 2014, 7 percent in 2015, 11 percent in 2016, and a projected 10 percent in 2017).
But in 2009, the ACA’s cheerleaders described it in much different terms.
...
But as a matter of policy, PwC was right and the cheerleaders and Democratic policymakers were wrong. The ACA’s exchanges were designed poorly, and premiums did become unaffordable for millions.
...
As Bill Clinton put it, "You’ve got this crazy system where … people that are out there busting it —sometimes 60 hours a week — wind up with their premiums doubled and their coverage cut in half." That’s why ACA exchange enrollment has fallen 9 million short of initial estimates.
The people who implemented the markets were ignorant and arrogant, too
And Obamacare didn’t suffer only from a flawed blueprint. It was also implemented by people with poor knowledge of how health insurance markets worked.
...
As those higher premiums started to become public, ACA cheerleaders engaged in another round of shoot-the-messenger, hoping that ignoring rate shock would make it go away. That didn’t work either. Instead, policymakers came upon the "solution" of simply rejecting insurers’ proposed rate increases, and forcing them to lose money. Insurers, having exhausted their options to participate in the exchanges and remain solvent, began heading for the exits.
A "public option" would only add to the problems
...
Instead of reconsidering the ACA’s thicket of costly and contradictory regulations, the law’s cheerleaders remain romantically attached to the unlikely notion that a "public option" could lower premiums — unlikely because it would only succeed if the government-run insurer paid doctors and hospitals far less than private insurers do, and forced providers to accept those lower rates.
...
More: http://www.vox.com/the-big-idea/2016/10/7/13191250/obamacare-exchanges-crisis-arrogant-progressives