The Affordable Care Act has turned six and not one of President Obama’s vaunted promises has come true—not one.
The closest thing to a fulfilled promise is the reduction in the number of uninsured. About 20 million Americans have been covered either through the health insurance exchanges or by expanding Medicaid, according to the administration.
But remember, Obama’s promise was “universal coverage,” and yet the Congressional Budget Office estimates there are still some 30 million uninsured Americans—and will be for the next decade.
So how about health care costs? Obama promised repeatedly that health insurance premiums for a family would drop $2,500 by the end of his first term. Of course, the coverage didn’t actually start until 2014, so we’ll give him a pass on the deadline. But health insurance premiums have increased significantly, especially for those who buy their own coverage.
For example, if my wife had not more than doubled her deductible to over $6,000, her premiums would have nearly tripled under Obamacare. We’re still paying much more, just not as much as if she’d kept her deductible the same. But then that policy was canceled, and the next one she chose was also canceled the following year—because Texas Blue Cross lost $400 million on that group in just one year.
Those cancellations make hash of Obama’s promise that if you like your policy or you doctor you can keep them.
Interestingly, one of the ways to achieve better care is for patients to stay with the same doctors over an extended period of time. Obamacare has wreaked havoc on those relationships as patients are forced to accept extremely limited provider networks just to get a premium they can afford.
Obamacare’s impact on employer coverage—which accounts for the large majority of Americans—and especially for large employers hasn’t been as great because those plans were already very comprehensive, but even their costs have gone up significantly.
Indeed, the complaints about health care costs are so numerous that the administration—as well as Democratic presidential candidate Hillary Clinton—have said they will now start focusing on lowering the cost of care. That announcement is as disingenuous as they come—because that’s what we were promised Obamacare would do.
Then there’s access to care. What Obama and the Democrats never understood was that access to health insurance is not the same as access to care. You can have health insurance and not have access to care, and you can be uninsured and get all the care you want—as long as you’re willing to pay for it.
Increasingly, doctors are refusing to take new, or any, Medicaid patients because the government reimbursement is so low. According to a 2014 Merritt Hawkins survey of five medical specialties (including family physicians and OB/GYNs) in 15 major metropolitan areas, only 45.7 percent of those doctors accepted new Medicaid patients, down from 55.4 percent in 2009. But those are averages. Broken down by cities, Medicaid acceptance in five cities (New York, San Diego, Atlanta, Los Angeles, and Denver) is under 40 percent. It’s 23.6 percent in Minneapolis and 23 percent in Dallas.
Of course, many doctors also refuse to take several of the Obamacare qualified plans because they, too, aren’t paying enough.
Insurance isn’t much good if doctors won’t accept it. Obama never learned that lesson.
But at least disrupting the entire health care market was worth it because Obamacare has helped so many people, right? That’s what the president regularly says. But a major national poll released in February found that only 15 percent of the public directly benefited from the ACA.
Perhaps the biggest broken Obamacare promise was one that Obama and the Democrats made to themselves. They all assured each other that if they passed the ACA the public would be so thrilled that Democrats would control Congress and the White House for decades. That may turn out to be the biggest lie of all.