Where, oh where is Obamacare? (Answer: tanked.)

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Americans have had six years of experience with Obamacare, or the Affordable Care Act (ACA). It is no more popular today than it was in 2010 when it barely passed Congress, with all the Republicans and many Democrats voting against it.

In no way has the law achieved the goals of its proponents. It has not provided universal health insurance coverage. It has not slowed the ever-rising cost of health care. It has not improved the quality of health care experienced by patients.

What Obamacare has done:

  • Increase the cost of health care for all Americans who do not receive health insurance as a government entitlement.
  • Increased the regulatory burden on all employers and individuals who purchase health insurance.
  • Made the health insurance industry more complex.
  • Increased taxes for millions of Americans.
  • Put access to health care for seniors in Medicare and for low-income people in Medicaid at risk.

To date, Obamacare has undergone 70 significant policy changes, including important deletions and delays. The Obama Administration unilaterally made 43 of these policy changes; Congress passed and the president signed 24 policy changes, and the U. S. Supreme Court made three significant rulings on the original law.

Even the ACA’s strongest supporters now admit the law was seriously flawed when it was enacted.

Proponents of the law argue that 20 million people now have health insurance because of Obamacare. Before the ACA became law, nearly 50 million Americans did not have insurance. Consequently, just 40 percent of those uninsured now have insurance.

Of those 20 million newly insured, approximately half were forced into the Medicaid entitlement, where studies show that medical results for enrollees are no better than outcomes for people without insurance.

The number of people nationally who lost their health insurance because of Obamacare is a moving target, but runs into the millions. In Washington state, the Insurance Commissioner’s figures show that more than 367,000 Washingtonians lost their existing health insurance and were forced into either the Medicaid entitlement program or the state government exchange.

Although Obamacare is costing us billions – if not trillions – in public dollars, private health care costs continue to rise for individuals and families. USA Today compiled data from the Obama Administration and reports that for 2016 in the ACA exchanges the average family deductible soared, including Washington state where it is up 76 percent, or about a $3,500 annual increase.

In Washington state the average health insurance premium in the individual market increased by 13.5 percent. The national average estimated increase for premiums in 2017 stands at 24 percent.

Even in the employer-based market, health insurance premiums continue increasing much faster than general inflation. The average family plan with employer-paid insurance now costs $18,000 a year, which is $4,400 more than before the ACA was enacted.

Almost 40 percent of Americans have enrolled in Medicare or Medicaid entitlement programs. The Congressional Budget Office reports that Medicare spending will double by 2026 to $1.29 trillion annually and that federal Medicaid spending will increase by 75 percent to $621 billion over the same time period.

Many state exchanges are now at risk of closing.  States that close their exchanges, of course, can push their residents into the federal exchange. This puts federal taxpayers at greater risk, not only for increased premium subsidies, but also for the higher overhead costs of running the exchanges.

Access to health care is a growing problem, especially for people in the Medicaid and Medicare entitlement programs. Just having health insurance on paper is no longer a guarantee of access to health care in practice.

Everyone agrees that the health care system was dysfunctional before the ACA became law. Going back to the situation as it existed in 2009 is not a solution. The country has two choices at this point – imposing more government control, or moving toward more patient control.

In November, Americans clearly voted for a change in direction of the country. Health care accounts for 18 percent of our economy and is vitally important for all of us. Instead of more government control, Americans are ready for a system change to more patient control which would maintain quality, access, and decreased costs.

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Dr. Stark is a retired cardiothoracic surgeon. He is the author of two books on national healthcare issues, including Our Health Care Crisis, How it Happened, and How We Can Fix It, and an in-depth study on the impact of the Affordable Care Act (ACA) in Washington State. He has testified before three Congressional committees on the ACA. He graduated from the University of Nebraska College of Medicine, served residencies in Seattle and the University of Utah, practiced in Tacoma, and became a co-founder of the open heart surgery program at Overlake Hospital in Bellevue.

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