The Affordable Care Act was a con from the get-go.
President Obama and his acolytes decided a people reeling from the Great Recession wouldn’t support an expensive new program that only served the poor through Medicaid expansion and working class by subsidizing premiums.
So they sold it as a sweeping reform that would benefit almost all Americans – the vast majority of whom were covered and content with their coverage – by lowering costs and delivering better care.
The key falsehood Obama used to sell his plan – the promise that you could keep your current doctor or health care plan – was clearly aimed at those who were already insured.
Sign Up and Save
Get six months of free digital access to The News & Observer
The American people made Democrats pay a heavy price for this falsehood and other missteps in federal, state and local elections, including the GOP’s return to power in North Carolina after more than a century in the wilderness.
In the years since, through countless glitches, price increases and public outcry, Democrats and their media allies further damaged their credibility by insisting the law was delivering on its promise.
If they had been honest from the start, they might have had a point. Today, about 14.4 million Americans get care through Medicaid expansion. Another 10 million Americans – including 475,000 North Carolinians – receive subsidies that make coverage affordable.
We still don’t know how much this expanded access has improved health outcomes, though some studies suggest the seemingly obvious point that it must have.
ACA cheerleaders are hailing Blue Cross and Blue Shield’s announcement that Obamacare prices will decrease an average of 4.1 percent for most Tar Heels next year while residents of 10 Raleigh/Durham area counties will see premiums drop about 21 percent.
This happy news, however, comes after years of enormous average rate increases: a 32.5% for 2016; 24.3% for 2017 and 14.1% for 2018.
And while supporters point to these price drops as proof the law is getting stronger, they actually highlight one of its weaknesses. BCBS is controlling skyrocketing costs by narrowing its network of providers, giving customers fewer options.
In fairness, BCBS said the rates might have fallen even more but for actions taken in Washington.
What did the dastardly Republicans do to sabotage the law?
First, they defended the separation of powers and the rule of law by winning a lawsuit that ended billions of dollars in cost sharing reduction subsidies the Obama administration was illegally paying to insurance companies.
Second, they ended the individual mandate to buy insurance, finally providing relief to the millions of middle class Americans punished by the law they were told would help them.
This is not a small group. While 10 million people have been insulated from rate increases through subsidies, another five million were paying full freight in 2017.
I was one of them. In 2014, my family of five paid $440 per month for a high deductible plan. This year our Obamacare bill was close to $2,000 for essentially the same insurance.
A North Carolinian I know who recently secured comparable employer-based insurance, said it costs $886 month – of which he pays half. Why that insurance costs so much less than ACA policies is another story.
The mandate’s death means insurers can once again sell the short-term plans Obama essentially regulated out of existence in 2016 to force people to buy ACA policies.
The Wall Street Journal reported that at the end of 2016 those policies cost about $124 per month “while an unsubsidized Obamacare plan averaged $393.”
These policies are not as comprehensive as ACA compliant policies. Democrats have derided them as “junk” insurance, making their usual argument that they should not be offered because they allow Americans to make bad decisions.
But they do address a deeper truth: that the ACA shafted the middle class – not just the 5 million people paying through the nose for unsubsidized plans, but the tens of millions more who remain uninsured.
In 2017 the number of people buying unsubsidized plans fell by 20 percent.
As Health and Human Services Secretary Alex M. Azar recently noted, “Obamacare has forced unsubsidized Americans to choose between unaffordable insurance and no insurance at all.”
That’s not what we were promised.