October 9 2012
Our televisions are filled with Democrats and Republicans talking -- often yelling -- past each other. When it comes to health care, Democrats emphasize the benefits of the President's reforms while Republicans harp on the costs. Both have a point: Insurance coverage will expand somewhat under ObamaCare, and the law (weighing in at $1.7 trillion in new spending) is expensive.
But something is missing from this debate: How will this health law affect the options we have and our experience when buying insurance and seeking care? Upon close examination, sadly the "benefits" of the law don't seem all that beneficial, and the costs become undeniable.
Start with young adults: Many Americans applauded the requirement that all insurance companies must allow families to keep adult children up to age 26 on their plan, and about 3 million young adults have made use of this new mandate.
There are real costs associated with this mandate. In fact, this one provision increased the average family premium -- even for families that didn't add adult dependents -- by $150-450 in 2011.
But the monetary costs are a small part of the story.
The truth is, the health law is dramatically reducing options for those young adults who are unemployed or hold jobs that don't offer insurance coverage. Many American youth today have parents who are unemployed, uninsured or otherwise unable to provide their adult child's insurance (some employers are even removing the option for dependent coverage to avoid the additional costs).
The architect of the new health law, MIT economist Jonathan Gruber, predicted that young workers who buy their own insurance will see a 19-30 percent increase in their premiums. Also, many colleges have dropped student health plans because the mandates and regulations in ObamaCare will make them unaffordable. This means fewer options, not more, for youth.
And people with pre-existing conditions? This was one of the law's biggest selling points. The CBO predicted that 700,000 people would sign up for a new federal high-risk program, but after two and half years of advertising the program, only 78,000 people have enrolled. Perhaps that's because they are required to go six months without any insurance before becoming eligible. Talk about a design flaw!
While it's true that some currently uninsured people will buy insurance under the new law (after all, there is a mandate!), did you know that even after ten years of implementation, the CBO predicts that 30 million people will remain uninsured? What will happen when they go to the emergency room and can't pay for their care? ...The same thing that happened before the health law: cost-shifting.
About one third of the newly insured -- that's 10-11 million people- - will be covered under Medicaid. This government insurance program for low-income people is already strapped for cash, and failing to serve beneficiaries well. Doctors must accept below-market reimbursement rates for Medicaid patients so many doctors refuse or delay appointments for this vulnerable population. As a result, some may gain health insurance but have little actual access to health care.
And despite the President's assurance, the Congressional Budget Office predicts that by 2019, 8-9 million people with employer-sponsored coverage will lose their current plan as employers seek to avoid the costs of the new law.
Yes, the law requires employers of 50 or more workers to provide insurance, but the associated penalty (tax?) is far too small to be effective, making the financial choice to drop coverage an easy one for many. A McKinsey & Co. survey shows thirty percent of employers answering they would "definitely or probably" stop offering health benefits, suggesting that the CBO's estimate is low.
Even those who will keep insurance coverage won't be untouched by the new law. According to Kaiser, only 48 percent of employer-sponsored plans have a "grandfathered" status, meaning half of Americans with employer insurance will see changes to their coverage -- changes they didn't ask for and don't need. As we've seen in the debate about sterilization and contraception, some changes will even force employers to violate their own moral consciences.
So both sides are right: The health law, as Democrats say, will benefit some, and the health law, as Republicans say, will cost everyone. After all, the law includes 21 new taxes. But a second look at the benefits will leave a lot of Americans disappointed. The intended result was expanded insurance coverage, but the real result will be higher premiums, fewer choices, and even decreased quality of care.
Hadley Heath is a policy analyst at Independent Women's Voice. For more information and for citations, visit www.healthreformquestions.com.