For Tens of Millions, Obamacare Is Working – NYTimes.com

How do you define success? On its face, it’s true more Americans have health insurance. Is that the sole measure of success?

First, those millions gaining insurance have created a tremendous ongoing liability in the form of tax subsidies that will only grow. That’s also true for the expanded coverage through Medicaid and employer plans. Second, Obamacare is not responsible for slowing health care costs. In fact, the opposite is true as we now see these are costs again beginning to escalate. Third, key provisions of Obamacare are already starting to show cracks or producing far less than promises benefits; co-op health insurance plans and Accountable Care Organizations are two examples. Fourth, the Affordable Care Act has indirectly lead to accelerated decline in employer-based coverage.

Obamacare has neither made health care affordable nor improved quality as is often claimed. It has benefited a small percentage of Americans to the detriment of other Americans who are seeing their benefits cut and out-of-pocket costs rise. As the years go by tax subsidy costs will continue to rise as will health care costs and employer-based coverage will decline. In 2018 when the so-called Cadillac tax hits millions more Americans will feel the negative impact when their benefits decline and their premium sharing increases. Given that state government plans are among the most generous and costly, the high value benefit tax will be borne by taxpayers as public unions oppose any reduction in benefits to bring them to acceptable levels under the law.

It seems to me that success or something working requires long-term sustainability and affordability and an equal sharing of the benefits and costs. Obamacare does not meet that test.

However, the New York Times is right about one thing. “The law’s cornerstone role in our health care system now seems assured,” like it or not, good or bad.

Ever since President Obama unveiled his health care plan in 2009, critics have questioned its lofty promise to bring affordable health insurance to millions of Americans.

Now statistics for the second year are largely in hand and the verdict is indisputable: Its disastrous 2013 rollout notwithstanding, the Affordable Care Act has achieved nearly all of its ambitious goals.

Most important, just three key provisions — creation of exchanges with subsidies for those who qualify, expansion of Medicaid and minimum standards for insurance plans — have benefited at least 31 million Americans.

Millions more have taken advantage of other features, such as the inability of insurance companies to deny coverage based on pre-existing conditions and the ability to include children up to age 26 in a parent’s plan.

Finally, while other promises of the Affordable Care Act are harder to measure, the slowdown in the rate of increase in health care costs and health insurance premium prices is at least partly due to the new law.

The program still faces challenges — notably a Supreme Court decision on subsidies expected in June that has the potential to undermine the program in many states. There are disappointments, too; millions of Americans faced higher premiums after being forced off substandard plans. Nonetheless, the law’s cornerstone role in our health care system now seems assured.

via For Tens of Millions, Obamacare Is Working – NYTimes.com.