ObamaCare


Obamacare’s Heavy Toll on Middle Class Americans

My AEI colleague Tom Miller and I have an article at e21 today on how Obamacare will lead to a massive redistribution of wealth away from the middle class.

In broad terms, the amount of redistribution is easily ascertained form the aggregate expenditures and taxes contained in ObamaCare. According to the Congressional Budget Office (CBO), in 2020, ObamaCare will spend $229 billion on a Medicaid expansion and a new subsidy program for health insurance. These expenditures will primarily benefit 29 million people newly enrolled in Medicaid and the insurance subsidy program. That works out to nearly $8,000 for every newly insured American, or about $21,000 per newly insured household.

Much of the rest of the legislation is devoted to extracting these resources from everyone else in the country — about 290 million people — who won’t benefit from the new spending programs, and doing so in way that obscures what’s taking place. For these Americans who already have insurance, the law contains nothing but new financial burdens, in the form of higher taxes, higher premiums for their existing plans, and lower benefits, particularly for those on Medicare.

Read more here.

posted by James C. Capretta | 10:23 am
Tags: Obamacare, taxes
File As: Health Care

A Fantasy-Based Case for Obamacare

I have a column up at National Review Online on how J. D. Kleinke is mistaken about there being a “conservative case for Obamacare.”

Does the 2010 law move us closer to an effectively functioning marketplace, as Kleinke claims? Or is it a significant and possibly irreversible step toward establishing federal-government control over the health-care system, as most conservatives contend?

One clue can be found in the views of those who were and are Obamacare’s strongest supporters, such as Peter Orszag, the president’s first director of the Office of Management and Budget. Orszag, along with just about every other left-leaning economist and health-policy analyst, has been spending much of his time lately attacking the notion that market-based reforms could work to control Medicare costs. In his view, the only solution is for the federal government to impose cost-control schemes. Of course, in the Medicare program, the government already has the power to impose such controls, which is why Orszag and others are so adamantly opposed to converting Medicare to a system built on true consumer choice.

Are these the views of someone who wants to see “conservative economic principles” reign supreme, as Kleinke asserts will occur under Obamacare? Of course not.

You can read the rest of the article here.

posted by James C. Capretta | 11:16 am
Tags: Obamacare
File As: Health Care

Curing the Pre-Existing Conditions of Obamacare

Tom Miller and I have a column in AEI’s The American on why Obamacare is the wrong way to cover pre-existing conditions.

The starting point for addressing the problem of pre-existing conditions is a proper perspective on its size. The claim that tens of millions of Americans are at risk of losing coverage defies common sense. ObamaCare included $5 billion in new funding to subsidize insurance for the millions who were supposedly sick and without options. Far from the alleged 65 million people,only 77,877 had signed up for the subsidized Pre-Existing Condition Insurance Plan by June 30 of this year. The truth is that most Americans with health problems are protected by rules passed years ago by Congress and state legislatures that prohibit discrimination against them in job-based insurance. Not surprisingly, those employer plans pay for hundreds of billions of dollars of claims each year—from workers with “pre-existing” health conditions.

But don’t get us wrong. The problem of gaps in coverage for pre-existing conditions is real and needs to be addressed. It affects several million Americans, and that’s far too many.

The fundamental cause of gaps in coverage is a lack of portable health insurance, not the likelihood that almost everyone will eventually suffer from some spells of poor health. Health problems are an inevitable pre-existing condition of life, especially as we live longer. Lack of access to health insurance, however, is largely due to two particular public policies that unfairly penalize individuals and families seeking coverage on their own, rather than through their employer’s group coverage.

You can read the rest of the column here.

posted by James C. Capretta | 11:28 am
Tags: Obamacare, pre-existing conditions
File As: Health Care

Health Care Costs and Obamacare

I have a new column at e21 rebutting Christine Romer’s latest defense of Obamacare’s cost control mechanisms:

Romer is right that rapidly rising health costs is the most serious threat to the nation’s long-term prosperity. Already, the rapid run-up in federal health entitlement spending is putting tremendous pressure on the federal budget. Between 1972 and 2011, federal spending on Medicare and Medicaid rose from 1.1 percent of GDP to 5.5 percent, according to the Congressional Budget Office (CBO). CBO’s latest projections indicate that spending on these programs, plus ObamaCare’s new entitlement spending, will push total health entitlement spending up to at least 8.4 percent of GDP by 2030. That’s a jump in spending of nearly 3 percentage points of GDP compared to today’s level — or the equivalent of another $500 billion in budget outlays.

But although Romer is right about the severity of the problem, she is dead wrong about ObamaCare’s role in addressing it. ObamaCare did not lay the foundation for sensible cost control, and did not partially ease budgetary pressures, as she asserts. Quite the contrary, ObamaCare will pour an ocean of gasoline on the health entitlement fire, and the supposed cost-control mechanisms are a mirage.

The rest of the column is here.

posted by James C. Capretta | 10:57 am
Tags: Obamacare, cost control
File As: Health Care

SCOTUS Post-Mortem

I have a column up at e21 on what today's Supreme Court ruling means for the future of Obamacare, and what opponents of that plan need to do to repeal and replace it:

Still, there’s no question that today’s ruling provides a boost to the administration and to the long-term prospects of ObamaCare. The future of ObamaCare now rests in the political and legislative arena -- perhaps appropriately, as that is where the fate of most important policy matters should be settled. ObamaCare opponents should be optimistic, because the public remains firmly opposed to the law, but also determined, because it won’t be easy.

You can read the rest of the article here.

posted by James C. Capretta | 4:30 pm
Tags: Supreme Court, Obamacare
File As: Health Care

Obamacare’s Failings Go Well Beyond the Individual Mandate and Medicaid

I have a new issue brief at the Heritage Foundation on four of the worst problems with Obamacare that are not under review by the Supreme Court. Here’s one:

Obamacare will exacerbate the nation’s already alarming entitlement spending and debt crises. Already, the dramatic rise in spending on Medicare and Medicaid is pushing the federal budget to the breaking point. Obamacare makes the problem much worse by creating two new additional entitlement programs in the form of a massive Medicaid expansion and a new premium credit entitlement for households with incomes between 138 percent and 400 percent of the federal poverty level. These two entitlement expansions are expected to add a minimum of 35 million Americans to the entitlement rolls when phased in, at an expense of more than $200 billion annually by the end of the decade.

You can read the rest of the article here.

posted by James C. Capretta | 12:45 pm
Tags: Obamacare, Supreme Court
File As: Health Care

The Case for Romney’s Health Care Plan in USA Today

I have an Op-Ed today in USA Today, offering an opposing viewpoint to their editorial:

This week, former Massachusetts governor Mitt Romney began to describe the kind of health care reform plan he would implement if he is elected president. It's the right vision, and it's very different from President Obama's.

The president's 2010 law is based on a government-centric approach to health care reform. The federal government, already heavily involved in regulating the health sector through Medicare and Medicaid, will have near-total control over all important decisions under the new law, including what's covered by insurance, where people go to access their coverage, and how doctors and hospitals should organize themselves.

Gov. Romney has a different focus....

You can read the rest of the piece here. (Note that their editors chose the title.)

posted by James C. Capretta | 12:25 pm
Tags: Obamacare, Mitt Romney
File As: Health Care

Supreme Suspense: Getting Ready for the Big Obamacare Decision

I have a new column up at e21 on how conservatives should be prepared for whatever the Supreme Court decision on Obamacare turns out to be:

...it’s possible to boil down the various scenarios to a handful that capture the most likely outcomes, and to examine the implications of those scenarios through both a policy and a political lens. Indeed, for those who have spent the past three years opposing ObamaCare, it’s critically important to be prepared for all eventualities because what the key players in this drama say and do in the days after the Court issues its decision could be just as important as the decision itself to the future of ObamaCare and American health care.

Scenario 1: The Court Upholds ObamaCare. What if the Court doesn’t strike down any provisions of ObamaCare? This is the scenario conservatives are loath to consider but ignore at their peril. It is certainly possible that the Court will find ObamaCare within the bounds of existing constitutional law, despite the many flaws in the administration’s legal defense that were exposed during oral arguments. If that happens, it will be seen as a severe blow to the ObamaCare opposition because so many conservatives have invested so much energy in the two-year-long legal case....

You can read the rest of the article here.

posted by James C. Capretta | 3:28 pm
Tags: Obamacare, Supreme Court
File As: Health Care

Obamacare Hurts Seniors

I have an article up at National Review Online debunking the claim, based on a report released by Fidelity Investments, that Obamacare will reduce health care costs for seniors:

For starters, as the Fidelity announcement indicates, the analysis conducted by the company is based only on seniors enrolled in the traditional fee-for-service Medicare program. That means it excludes seniors enrolled in the private-plan option available in Medicare, known as Medicare Advantage. Today, about 25 percent of Medicare beneficiaries are enrolled in Medicare Advantage plans. Excluding them from the analysis significantly distorts the findings.

In a report I prepared with Robert Book for the Heritage Foundation, we found that Obamacare will cut Medicare Advantage payment rates by an average of $3,700 per beneficiary in 2017, or 27 percent below the payment rates that would have been made without Obamacare. These cuts will translate directly into higher health-care costs for seniors. Seniors who remain in Medicare Advantage will face higher costs, because the cuts will force the plans to cut back on the benefits they offer and to charge higher cost-sharing for the services they do cover. Further, seniors who will be pushed out of Medicare Advantage and back into the traditional program will lose entirely the added benefits provided by most Medicare Advantage plans. None of this is captured in Fidelity’s analysis.

You can read the rest of the article here, and find the Fidelity study online here.

posted by James C. Capretta | 11:00 am
Tags: Obamacare, Medicare Advantage
File As: Health Care

Exposing the Medicare Double Count

Charles Blahous and I have a new column in the Wall Street Journal on how Obamacare tries to double-count certain revenue to twist its budget figures:

One of the enduring mysteries of President Obama's health law is how its spending constraints and payroll tax hikes on high earners can be used to shore up Medicare finances and at the same time pay for a massive new entitlement program. Isn't this double counting?

The short answer is: Yes, it is. You can't spend the same money twice. And so, thanks to the new health law, federal deficits and debt will be hundreds of billions of dollars higher in the next decade alone....

You can read the rest of our explanation of the Obama administration’s fiscal obfuscation here.

posted by James C. Capretta | 3:05 pm
Tags: Obamacare, Medicare, double-count
File As: Health Care

Previous  Next