Obamacare Already Breaking Promises to Reduce Costs, Insure Everyone

March 28, 2012

…and it hasn’t even been fully implemented yet.

At National Review Online, Avik Roy offers an thorough but concise overview of all that has happened in the last year relating to Obamacare, with copious links to his sources.  A few excerpts:

Massachusetts continued to give us a preview of what Obamacare would do to the country. In May, studies found that, contrary to what was promised, the new health-care regime increased emergency-room crowding, and increased already-long wait times for doctors’ appointments.

. . .

Outside the courtroom, the McKinsey Quarterly published an important survey that found that 30 percent of employers intended to “definitely or probably” stop offering health insurance to their workers after 2014, when Obamacare’s taxes and subsidies kick in. Among employers who were most familiar with the law’s features, 50 percent intended to drop coverage. Democrats flipped out, futilely attempting to portray McKinsey as a right-wing conspirator. (McKinsey’s employees gave far more to Obama than McCain in 2008.)

. . .

The Medicare chief actuary, Richard Foster, put out a report finding that Obamacare will triple the growth rate of net insurance costs.

. . .

The Joint Committee on Taxation put out a report saying that Obamacare’s subsidies take another 8 million Americans off the income-tax rolls, further separating taxpayers from subsidy recipients.

. . .

A commissioner for the Federal Trade Commission stated that Obamacare’s accountable-care organizations would likely lead to “higher costs and lower quality health care,” because merged providers would be able to force insurers to accept higher prices.

. . .

A new HHS report disclosed that per capita spending in Obamacare’s high-risk pools was double what states had previously projected.

. . .

The Congressional Budget Office’s new baseline established that eleven-year spending on Obamacare would equal $1.7 trillion, far more than the initial ten-year projection of $900 billion (over a different time frame). CBO also estimated that under the law 2 million fewer people would gain insurance coverage than previously projected.

. . .

It turned out that Jonathan Gruber, who had stated in 2009 that the law would “for sure” reduce the cost of non-group health insurance, was quietly telling state governments that the law would increase premium costs by 19 to 30 percent by 2016.

(links and emphasis in original)

The Supreme Court is hearing oral arguments this week (Monday, yesterday, and today) in the case about whether Obamacare is unconstitutional.  You can keep up with the latest developments and commentary at National Review Online and NRO’s the Corner and Critical Condition.

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20 Responses to “Obamacare Already Breaking Promises to Reduce Costs, Insure Everyone”

  1. Snoodickle Says:

    What about the Supreme Court arguments? All three of the regular posters on this blog are lawyers (I think?), shouldn’t we discuss the merits of the Supreme Court case?


  2. Sure, I’ll offer an opinion on the legal (constitutional) question: Both the text and the history of the Constitution make clear that it creates a federal government of limited, enumerated powers. I don’t think there’s any possible interpretation of the Constitution that both acknowledges such limits and allows Obamacare—other than goofy, legalistic interpretations that only someone who’s been to law school could think made sense.

    • Snoodickle Says:

      When you say Obamacare, I presume you’re referring to the individual mandate, because both sides of the litigation concede that other provisions of the law, such as the mandatory issue provision, are clearly constitutional. Thus, we are left with the narrow legal question of whether the individual mandate is permissible under either the Commerce Clause or the Tax Clause. Assuming the mandate is a penalty and not a tax, we are left with the Commerce Clause question. Because you are not very specific in your argument above, I guess I’m not clear on why you think the individual mandate (which, ironically, is the spawn of conservative thinking) is unconstitutional. It is a fascinating legal issue, no doubt, with compelling arguments on both sides.

      The two main positions that have been advanced go something like this.

      (1) You cannot create commerce (i.e. force individuals to purchase something) under the commerce clause, because if you could, there would be no limits to what the federal government can do under that power.

      (2) The consumption of health care clearly has a substantial effect on interstate commerce, and Congress can therefore require people who participate in the health care market, or are virtually assured of participating in it, to pay for the health care they are sure to receive in advance of receiving it (i.e. purchase health insurance). This is especially true when one considers that people who do not pay for health care in advance shift the costs of their care to the responsible citizens who do pay for their health care in advance, thus creating a system where some individuals are penalized by the negligent behavior of others.

      I am assuming that you subscribe to the first view, though I should note that Judge David Sutton (an avowed conservative and brilliant legal thinker) wholeheartedly subscribed to the second interpretation , so to say that only “goofy” lawyers could reasonably adopt that interpretation is a bold statement. I would love to have the discussion, though, as the case presents fascinating legal questions.


    • “(1) You cannot create commerce (i.e. force individuals to purchase something) under the commerce clause, because if you could, there would be no limits to what the federal government can do under that power.”

      OK. Do you think there would be any limits to what the federal government could do, if Obamacare were allowed?

      • Snoodickle Says:

        Of course there would. If a given activity does not have a substantial effect on interstate commerce, it cannot be regulated. You seem to conveniently forget about that. But beyond that, there would be cognizable limits on the power of Congress to compel individuals to purchase a product or service. The limit would be as follows: only if the product or service is of such a nature that almost all individuals are inevitably going to enter the market for it at some point, and the failure of individuals to pay for the product in advance will shift significant costs to other individuals in that market, and such failure has a substantial effect on interstate commerce, only then can the government force the individual to pay for the product or service in advance. This limiting principle may mean that health insurance is the only product Congress can force individuals to purchase, I don’t know. And this is also where Alitos burial insurance hypothetical as well as Scalias broccoli hypothetical fail. The failure of individuals to purchase burial insurance does not increase costs for other market participants precisely because funeral parlors and cemeteries do not have to accept unpaid for corpses, whereas hospitals do have to accept sick people no matter if they are insured or not. The broccoli thing just doesn’t make sense. I challenge you though to come up with a product or service that Congress could force individuals to purchase under that limiting principle. They may be out there, but they’re not myriad by any means. Now were thinking like lawyers!

        Disclaimer: this post was written from my I phone and could very well be riddled with typographical errors.


      • “Now were thinking like lawyers!”

        We certainly are. I called it, if you’ll pardon my saying so: “goofy, legalistic interpretations that only someone who’s been to law school could think made sense.”

        Anyway you’ve just “challenged” me to find any other product or service that Congress could likewise mandate under—and called out Alito and Scalia for not properly following—an ad hoc limiting “principle” that you just made up, tailor-made to fit the mandate at issue in this case. Is there anything I’m missing? If the court rules as you suggest, I’m sure that this limiting principle will hold very well—until the next time Congress expands its reach even further, at which point you’ll be telling me why I shouldn’t worry because there’s a new limiting principle that allows only that further reach—and so on.

        Remember Griswold vs. Connecticut, in which the court made such a big deal about the sanctity of marriage, and marital privacy was the only interest strong enough to outweigh and invalidate the state’s law against contraceptives? Then a case came up and presented the question of whether the unmarried should also have a constitutional “right” to contraceptives, and the court said yes, of course, wave it on through.

        Why not stick to what the Constitution actually says? Where did it ever mention marital privacy? Where did it ever mention whether “the failure of individuals to pay for [a] product in advance will shift significant costs to other individuals in that market”?


      • By the way, does the irony bother you that health insurance is one of the few things in which Congress has basically banned interstate commerce (to prevent people from getting around their own state’s onerous regulations on what a health-insurance plan has to cover by buying health insurance across state lines), and now the government is trying to argue that the “substantial effects” on interstate commerce (of a thing that would have been interstate commerce itself but for their banning it) justify the mandate? Should there be a presumption against allowing Congress to do something under the commerce clause when Congress has made sure there isn’t interstate commerce in a thing?

      • Snoodickle Says:

        Where in the Constitution does it say that Congress can’t force individuals to purchase something? That said, I’m not even arguing that the individual mandate is constitutional, it very well may not be. What I did was provide your limiting principle, which you failed to make a counter argument against other than the Court may decide eventually that it doesn’t want to follow its principle. It seems my principle has defeated you.


      • So you’re admitting that you just made it up, based on nothing but the statute you wanted it to accommodate? It seems your principle has defeated itself.

      • Snoodickle Says:

        What do you mean “made it up”? I crafted a limiting principle based on the facts of the case. I didn’t make it up any more than the Court “made up” the three part test in Lopez, or “made up” the principle that the government can’t execute juveniles. You asked for a limiting principle, I gave you one, it’s incumbent upon you to show how that principle would apply to more situations than one, or to enough situations such that it’s not sufficiently limiting. If you can’t do that, you should admit as much.


      • “What do you mean ‘made it up’? I crafted a limiting principle based on the facts of the case.”

        You’re serious, aren’t you? I’m saying that sounds totally ridiculous. You’re admitting that the “principle” is not derived from the text or history of the Constitution, or even past precedents. In other words, there has been no effort to look to fixed authorities (located in the past) and discern the right answer; you’re deciding how you want the case to come out (government wins, Obamacare allowed), and unabashedly working backward from your desired result to make up the “principle” that produces it.

        I’m saying that’s straight ridiculous.

      • Snoodickle Says:

        It is based on precedent to the extent that it requires that an activity substantially affect interstate commerce. See Lopez. Moreover, it is an issue of first impression. That means that there are no precedents directly on point, if I’m not mistaken. And because the principle requires that an activity substantially affect interstate commerce, it is indeed rooted in the text of the Constitution, which specifically refers to regulating “interstate commerce.” Instead of making meaningless complaints, why not try to come up with a substantive counterargument?

      • con law 101? Says:

        “Where in the Constitution does it say that Congress can’t force individuals to purchase something?”

        I’m no lawyer, but isn’t it sortof Constitutional Law 101 that the federal government is a government of enumerated powers? Isn’t that like the first thing you learn? And the states are the ones where you look for what they can’t do?

      • Snoodickle Says:

        Youre missing the point. Yes, the federal government is one of enumerated powers, but once you determine that an activity substantially affects interstate commerce, you have to determine whether Congress can force individuals to purchase something pursuant to its commerce power. That’s precisely whats at issue in the health care case. My point is that the text of the constitution does not foreclose the possibility of the federal government forcing someone to purchase a product, and that a result upholding Obamacare could therefore be harmonious with that text.

  3. Tevyeh Says:

    You’re missing the point, Chillingworth. Obamacare was *intended* to provide affordable health care for all. Its opponents are all mean-spirited jerks who want people to suffer. Our evaluation of policy should be primarily informed by our intuitive assessment of subjective motivations. So what if Obamacare is turning out to be a trainwreck, as the meanies predicted? Details, details…


  4. […] “Obamacare Already Breaking Promises to Reduce Costs, Insure Everyone” […]


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