The ObamaCare Disappearing Act

ObamaCare is not disappearing as a horse-collar around our necks, but it is disappearing as a provider of actual decent health care.  Many taxpayers are opting to pay the tax penalty rather than pay exorbitant health insurance premiums, only then to find out that the very high deductibles prevent them from using their health insurance at all.  Indeed, many with ObamaCare health insurance cannot afford to actually go to the doctor for health care after their impoverishment by the high premiums.  As a result, insurers operating in the ObamaCare exchange health insurance market are generally suffering huge losses.  Far too few healthy people are signing up for the ObamaCare abomination, while unhealthy people are signing up.

Consequently, Aetna, United Healthcare, Humana, and others have made huge reductions in the number of markets they plan to serve in 2017.  According to a study by the Kaiser Family Foundation, 31% of the counties in the U.S. will be served by only one insurer in 2017, while another 31% of the counties will have only two insurers under ObamaCare exchanges.  19% of enrollees will have but one insurer to choose from and another 19% will have only two to choose from.  Once again, an Obama promise to increase competition in the health insurance market turns out to be a lie. Yes, he might only have made a wrong prediction, but given the known history of his known lies, it is more likely that he knowingly lied about this as well.

As John Goodman has noted, the only plans that have avoided losses are those that offer services after the fashion of Medicaid and are operated by Medicaid contractors.  Medicaid level service is well known for its awfulness.  About 75% of the plans to be offered in 2017 are estimated to be for either Health Maintenance Organizations (HMOs) or Exclusive Provider Organizations (EPOs), according to a McKinsey & Co. analysis of regulatory filings for 18 states and the District of Columbia (reported in Wall St. Journal, 1 Sep 2016).  So only 25% of the plans will offer a wider choice of health care providers as are usually found in Preferred Provider Organizations (PPOs).  About 15% of ObamaCare exchange users will have no choice of a PPO available to them at all.  This is another case of the falsity of the statement that "If you like your doctor (or hospital), you may keep him."

As recently as March 2015, the Congressional Budget Office (CBO) was claiming that in 2016 there would be 21 million ObamaCare exchange enrollees.  However, in January 2016 the CBO reduced its estimate of 2016 enrollees by 8 million people to 13 million, of whom 11 million would receive subsidies.  What is more, the CBO, despite increasing tax penalities, expects the ObamaCare exchange enrollment to maximize at 16 million in 2018 and remain at that level through 2023, despite a growing U.S. population.  The White House has now projected an even lower level of 2016 exchange enrollees at 10.4 million.

For the 2014 tax year, 7.5 million taxpayers paid the ObamaCare penalty tax, which was far in excess of government estimates.  H&R Block said the average ObamaCare tax penalty was $172 in 2014. The average penalty paid in 2015, was up to $383.  While the IRS had released the information on the number of taxpayers paying the penalty for 2014 by early July 2015, that information does not seem to be available yet for the tax year 2015.  Perhaps it is too embarrassing to the Obama administration.

In the Fall of 2015, we knew that there were 10.5 million 2014 tax returns eligible for ObamaCare exchange insurance which did not claim having it.  12 million tax returns claimed exemptions from ObamaCare insurance, 5.1 million failed to check having qualifying insurance and paid no penalty tax, and 4.5 million taxpayer tax filings received ObamaCare subsidies.  Note that the number of taxpayers paying the ObamaCare fine or penalty tax exceeds the number of taxpayers receiving a subsidy by 3 million returns.  About 6% of taxpayers are covered by insurance under ObamaCare exchanges.

About 300,000 taxpayers in 2015 apparently paid the tax penalty despite being eligible for an exemption.  This is about all we know about 2015 tax returns on this subject.

According to the CBO, the 11 million receiving ObamaCare subsidies in 2016 represents 3.4% of the population of about 324.4 million people.  Many of these people had insurance without a subsidy prior to ObamaCare.

Much of the grief of the insurance companies is due to the fact that about 8 million fewer people have signed up for ObamaCare exchange health insurance in 2016 than had been projected in March of 2015 by the CBO and presumably by the health insurers.  These 8 million abstainers are generally much younger and much healthier than those who have signed up.  The premiums they were to pay were supposed to act like a transfer payment to those who had more health problems.  Even those who by age may be subject to more health problems, but are not now experiencing them, are often not signing up since they know they can do so whenever their health deteriorates.  Of course, such people used to actually pay for insurance because they could afford.  Thanks to ObamaCare many of them cannot afford it now, so they simply wait to sign up when they need it.

ObamaCare has lowered the quality of health care in the USA greatly.  It is now in large part limited to the low quality of Medicaid.  People on it have decreasing choices of doctors and hospitals, more limited care due to a greater need for cost-cutting, and they are excluded from many of the better hospitals and doctors, who rightly charge more for their services.  These terrible costs, as well as the terrible cost in our liberty, have been incurred in the name of a very small percentage of the population.  Meanwhile, 7.5 million taxpayers are paying ObamaCare penalty taxes for absolutely no value to their lives.  Another 2 million people are suffering under the higher premiums and deductibles of ObamaCare without getting any subsidy in return.

Prior to the passage of ObamaCare by an undemocratic Democrat dominated Congress and President, the justification in the socialist press was largely based on a claim that 47 million Americans had no health insurance.  Now we have ObamaCare and only some unknown fraction of the 13 million people on it in 2016 might have been without insurance if it did not exist.  We know from a McKensey & Co. survey in April 2014 that only 22% of the enrollees then signed up and who had paid their premiums had been previously uninsured.  If we suppose that the number of previously uninsured on ObamaCare is now 30%, that number is only 3.9 million people or 1.2% of the population.  The claim that a problem for 47 million people was to be addressed was almost certainly more than a ten-fold exaggeration.

It is a very sad commentary on Americans that they have not insisted on making this abysmal boondoggle a much greater factor in the 2016 elections than they have.  The self-ownership of our minds and bodies deserves much more diligent attention, as does the destruction of much of our health care system.

13 Nov 2016 Update:  Very late in the 2016 election campaign, Trump finally started to make a consistent issue of ObamaCare.  Had he not done so, it is easy to speculate that he would not have won in several of the states in which his margin of victory was very slender.