National health care reform: First year report card
The Patient Protection and Affordable Care Act (PPACA) became law one year ago and ultimately will impact one sixth of the United States’ economy. Never before has such comprehensive social legislation been passed by Congress with such a strictly partisan vote. Although full implementation will take at least eight years, we now have twelve months of experience with the new health care reform. How successful has it been?
President Obama promised the law would “bend the cost curve (of health care) down.” The original cost of the legislation was estimated at roughly $1 trillion, with one half of the funding to come from cuts to Medicare and the other half to come from new taxes. However, Congress subsequently voted to defer $280 billion in cuts to Medicare providers, and the planned elimination of Medicare Advantage has been deferred until at least after the 2012 election, so the promised savings will not be achieved.
From 2010 to 2019, PPACA funding is based on ten years of taxes, but only six years of benefits, which start in 2014. From 2012 to 2021, the cost goes up to $1.4 trillion, and from 2020 to 2029 the cost is now estimated to be $2.5 trillion.
Consequently, it is now obvious to everyone that the cost of the new law will add billions, if not trillions, of dollars to the national debt and will not hold health care costs down.
Over the past year, the constitutionality of the law has been challenged by twenty eight states and many organizations and individuals. Never before has the federal government forced Americans to purchase a private product such as health insurance. More than ten states have either considered or have passed legislation that nullifies the PPACA mandate and protects their citizens from federal takeover of their health care.
The new law remains very unpopular. The Rasmussen poll has consistently shown between 52 to 60 percent of the American public want the law repealed. A recent Kaiser health tracking poll revealed 59 percent of seniors had an unfavorable opinion of the law and only 32 percent had a favorable opinion. When Kaiser polled “all” Americans, 48 percent had an unfavorable opinion and 43 percent had a favorable opinion. However, only 24 percent of “all” Americans polled were Republicans, so clearly the survey sample was biased in a liberal direction.
The federal government has already granted health care waivers to over nine hundred companies and organizations. These waivers exempt the recipients from participating in parts, or in some cases all of the PPACA. Waivers themselves may be unconstitutional, because they exempt some people from the equal application of the law, but they do demonstrate the unpopularity of the new law and the political influence necessary to avoid it.
A big part of the PPACA is the expansion of the Medicaid program, a combined federal and state health care entitlement. Because of huge costs, many states have applied for waivers to limit federal control over their existing Medicaid programs.
Proponents of the PPACA argue that one of the immediate benefits of the law is the tax credit small businesses receive for providing employee health insurance. Unfortunately, the law has very specific requirements for the number of employees and the average employee wage needed to qualify for the tax credit. These requirements have severely limited the availability and use of these small business tax credits.
Finally, a recent vote in the United States House of Representatives showed an overwhelming majority of members favored repeal of the PPACA. Medicare and Medicaid passed in 1965 with a majority of Congress and a majority of the American public in support. The PPACA was unpopular when passed a year ago. It has not shown any increase in popularity over the past year, but it has clearly demonstrated its inherent flaws and predicted adverse consequences to the American public.