It is possible to say that health care insurance in this country is unfair, and that Obamacare (ACA) seeks to address an equity imbalance between the sick and healthy in this country. It is possible to claim that the law has many good intentions.
There are four things that it is not possible to claim.
1. We Know What Obamacare Will Cost
The non-partisan CBO has updated its 10-year forecast which says that the projected cost basically doubled from 2010 to 2012 to 1.7 trillion. The reason for the increase? The 10-year projections in 2010 included only six years implemented law where as the figures from 2012 includes eightyears. Factcheck says that the projected 10-year cost of Obamacare increased about 9% in 2012 when compared on an apple to apple basis which included sixyears of enactment.
We have no idea what this program will cost.
2. A New Entitlement Will Fix Our Budget Problems
It is not possible to say that spending nearly $2 trillion over 10 years will not affect our budget problems.
The ACA includes taxes and penalties which will generate more than $1 trillion in new revenue over the next 10 years. Clearly this revenue could be used to reduce the interest burden on millennials by reducing the government's debt load. This money could be used to renew programs, like Head Start, cut back by the sequester. This money could be used to refinance student loans on more favorable terms.
Congress could use this money to shore up existing entitlement programs. Social Security DI is projected to reach insolvency in 2016. Medicare is projected to reach insolvency in 2026. CBO's latest projection says that Social Security OAS will reach insolvency in 2031. All of these projections are based on a good economy.
In the face of an imminent shutdown of government services caused in part by entitlement spending, Washington launches a new entitlement.
3. Health Care Spending Will Decrease
It is not possible to say that adding millions of people to the health care system will lower costs. It is not possible to say that requiring insurance companies to cover the cost of pre-existing conditions without any lifetime cap will lower cost of insurance.
The White House counters that the slow-down in health care spending is a sign of the ACA's success. Politifact has doubts about this claim. ABC News has doubts. Factcheck has doubts. Comically enough, the agency which provided the data on which Obama based his claim said: "Obamacare had "no discernible impact." This skepticism isn't surprising considering that some of the data cited by the White House predates the enactment of the ACA.
We will spend more on health care, but we don't know how much.
4. You Are Unaffected
It isn't possible to say that you are unaffected by this law whether you participate in the health care exchange or not. The law contains higher of taxes and regulation, the cost of which is passed on by employers and businesses to employees and consumers. CBO has projected that a million jobs will be lost because of this law.
The law spreads the revenue sources across a wide range of taxes to reduce the visibility of the system to the tax payer. The law includes direct taxes such as the individual mandate tax, lowering deductibility of medical expenses, and increasing restrictions on Health Savings Accounts. The law contains hidden taxes which are taxes that are applied to businesses but are ultimately paid for by consumers. These include the insurers tax, the Medical Device Tax, Pharmaceutical Companies Tax, and the Cadillac Tax. Virtually all of the sources of revenue for ACA make health care less affordable.
The government prefers taxation by regulation because the someone else is blamed for the cost. The ACA requires that insurance cover pre-existing conditions. It has removed the caps that insurance companies insert into policies to limit their exposure to sick people. Believe it or not, insurance companies have read this law, and they are already pricing these regulations into premiums.
Insurers aren't waiting. Robert Samuelson reports small businesses face health insurance premium increases of 30% this year. Sally Pipes of Forbes reports that 70% of CFOs rate health care costs as their primary economic concern. Humana has informed me that the cost of my ACA compliant insurance is roughly 10% higher than my existing coverage.
The cold reality is spelled out by Bonny Salmeri of Charlotte who is facing higher premiums because her employer dropped her coverage. She is facing the uncertainty of health insurance because the ACA's rollout is understandably difficult. The problem for her is that it isn't possible to tell her when or whether her problem will get better.