© Josh Sager – July 2013
During the week of July 15th, 2013, two pieces of news broke concerning the Affordable Care Act (AKA “ObamaCare): conservatives in the federal legislature took their 38th doomed vote to repeal or disrupt the implementation of ObamaCare and the New York Times reported that premiums in New York could be cut by an average of 50% due to the law.
These radically contrasting pieces of news illustrate an unusual situation, where the right wing has found itself attempting to repeal a piece of legislation which has not only been successful, but was based upon their previous plans.
Despite what the right wing may now claim, a market-based solution to healthcare is a right wing idea, not a progressive one—a progressive plan would involve the nationalization of healthcare providers and massive reductions to the private health insurance markets.
The Affordable Care Act is based upon the Massachusetts healthcare plan (“RomneyCare”) and the right wing alternative to the left’s socialized healthcare. Rather than adopt a form of socialized medicine, as is common in much of Europe, ObamaCare and RomneyCare utilize market competition and an individual mandate to widen the insurance pools and decrease prices. In an ideal situation, such a plan would retain the current private-insurer model, while radically expanding coverage and affordability.
In the past, high ranking right wing politicians—including Mitt Romney, John McCain, and Bob Dole—have supported (or, in Romney’s case, signed into law) healthcare plans based around the individual mandate which very closely resemble ObamaCare. In fact, the entire concept of the mandate-based healthcare plan was originally popularized by the right wing Heritage Foundation.
“Require all households to purchase at least a basic package of insurance, unless they are covered by Medicaid, Medicare, or other government health programs. The private insurance market would be reformed to make a standard basic package available to all at an acceptable price.”
–The Heritage Foundation’s Consumer Choice Health Plan, 1993–2007–
Given the fact that ObamaCare is based upon conservative ideas, conservatives should be celebrating the initial success of ObamaCare; after all, ObamaCare is far closer to the conservative solution to healthcare availability than it is to a progressive model. While many (myself included) believe that a progressive healthcare solution would more efficiently increase coverage and decrease costs, the fact remains that the conservative policies of the ACA have demonstrated a high level of success. In effect, my primary complaint against the ACA is that I see it as the second best option on the table—not as effective as the truly progressive healthcare option (ask a western European what it is like to be uninsured and unable to afford healthcare) but still a very beneficial step in the right direction.
Here are a few examples of the positive effects of the ACA:
- The eliminations of pre-existing condition exclusions and lifetime caps on coverage which often left sick people unable to obtain insurance or get their providers to cover their costs if they became ill with an expensive-to-treat illness (ex. cancer).
- Students can now stay on their parent’s healthcare plans until they are 26 years old—this has been particularly beneficial because of the inability of many recent college graduates to get well-paying jobs with included healthcare benefits.
- Insurance companies are now unable to spend more than 20% of their customers’ premiums on administrative costs and other non-medical expenses. This portion of the law has led to rebate checks for approximately 8.5 million Americans.
- Healthcare premiums are either declining or increasing less rapidly then was projected without the influence of ObamaCare. These reductions are widely varied, ranging from minimal reductions in premiums in some states (ex. Massachusetts) to astounding reductions in others (as much as 50% in New York). Overall, the average premium reduction has been between 10% and 18% according to a Department of Health and Human Services Report.
The previously mentioned positive results of ObamaCare are only the initial benefits of the law—several key aspects, including the Medicaid expansion and state health insurance exchanges have yet to be set up. Hopefully, once the law is fully implemented, there will be even more positive results of ObamaCare.
State healthcare exchanges allow for increased competition between different health care markets and prices are very likely to be driven down by market competition.
The Medicaid expansion will subsidize the health insurance of poor people and will allow them to access health care in a way which was previously impossible. This expansion has the potential to be extremely beneficial, as those who most need health care are finally going to have access to it at affordable rates. That said, there are going to be issues on the provider-side of healthcare due to this expansion which will need to be ironed out; Medicaid pays decreased prices to healthcare providers and the flood of new Medicaid applicants will likely create issues for some doctors’ bottom lines.
Despite its initial success (and the potential for future improvements), political considerations by the right wing have led them to completely abandon their previous plan and deride it as socialist. In order to attack Obama and stir up their base, the right wing has engaged in endless political theater and propaganda against their old plan. This campaign has been successful in turning many people against the law, and approximately half of the country now has a negative view of ObamaCare. Eventually, as ObamaCare’s benefits become more apparent to the population, people will begin to switch opinions on it and public support will rise (this isn’t uncommon for new healthcare programs and an identical opinion switch occurred after the implementation of Medicare Part D).
The great irony of this situation is that, if ObamaCare keeps on its very positive trajectory, the result very well may be Obama taking all of the credit for the positive effects of the right wing’s healthcare plan, leaving conservatives with nothing more than dozens of failed attempts to repeal their own idea.