Obamacare's broken promises, Obama's broken second term
Thanks to the Affordable Care Act, President Obama has lost credibility as a leader and effective executive with most Americans.
A good CEO must work within the strengths and limitations of his organization—then execute effectively to deliver on the promises he makes.
Enter the president’s signature program:
The ACA website, HealthCare.gov, even with many efforts at improvement, is simply not easy to use or adequately effective.
As of November 30, 365,000 Americans signed up for insurance via that website and the other exchanges set up by the states. This is well short of the Administration’s target, and makes unlikely that seven million will sign up by March 31, as expected by the Department of Health and Human Services.
Many who have failed to participate are young and healthy, and whose participation is needed to make the insurance policies offered viable.
When new insurance policies take effect next year, many Americans who successfully navigated the federal website will find they have signed up for nothing at all. Critical information about policyholders, dependents, incomes and the like has not been effectively transmitted to insurance companies for about one in ten applicants. And the software needed to pay insurance companies federal subsidies promised for low and moderate income Americans is not yet completed.
Insurance companies won’t have enough cash to pay claims. Doctors will be scrambling to collect money directly from patients, who may not have the ability to pay, and to keep their practices solvent.
Right out of the box, the ACA declared many individual and group insurance policies to be inadequate and illegal. After a public uproar, the president declared those could be reinstated for one year, but many state insurance commissioners balked at this unworkable reversal of policy. Insurance companies simply can’t recreate the risk pools of customers that made those policies viable.
Once out, the jelly could not be put back into the jar.
Across the full range of policies sold directly to individuals and provided groups through employers, insurance companies are eliminating doctors and hospitals from networks to meet arbitrary Obamacare mandates. Americans are scrambling to find new physicians, who are often overwhelmed and sometimes cannot provide essential services some patients need.
Policies now cancelled paid millions of dollars in critical services, including cancer treatments by highly specialized clinics. Now they are being replaced by new contracts that don’t pay for those life-saving treatments, yet are cluttered with unneeded benefits, such as pediatric vision services for childless couples in their 50s.
Sadly, some Americans face death when old policies lapse and can no longer pay for the care they need.
Overall, premium costs are rocketing, not because old coverage was inadequate or new coverage is better, but because the ACA created markets that are less competitive than before.
The ACA sought to create new, more effective markets in over 3000 cities and counties across America. This is proving an unworkable promise in a health care sector as large as the entire economy of France.
In many locales, owing to uncertainty about size and age characteristics of the new pools of customers to be served, the number of insurance companies participating has declined. Competitive pressures on insurers to negotiate favourable rates with hospitals and other facilities are greatly diminished.
These insurers are often quoting much higher rates, wholly frustrating the purpose of “bending the curve” as the president euphemistically refers to the ACA’s efforts to halt the upward trajectory of health care costs.
The ACA is a bureaucratic nightmare and a bad trick played on most Americans
Now the president lacks the trust and credibility to pursue important second term initiatives like immigration reform.
The president has only his hubris to blame.
Peter Morici, an economist and professor at the University of Maryland Robert H. Smith School of Business, is a widely published columnist.