ObamaCare at Two

Today is the second anniversary of President Obama’s signing into law the Patient Protection and Affordable Care Act, colloquially known as “ObamaCare.” Despite front-loading benefits in the hope of winning opponents over before the costs start kicking in in 2014, public opinion against the law remains exceptionally high, and is seen increasingly as a political liability to Democrats seeking reelection this year, including the President:

President Barack Obama doesn’t plan to tout the law publicly on Friday, the second anniversary of his signing the bill. A senior administration official said his involvement politicizes the matter, which makes it all but impossible to change negative public opinion about the law.

This is an astounding change from the political hay the President and the Democrats then in majority made in celebrating its passage—remember Speaker of the House Nancy Pelosi and her entourage’s victorious march through protestors (pictured above)?

What’s changed? As per usual, reality has diverged from predictions:

While President Obama promised that passage of the law would result in the average family’s premium dropping by $2,500 by the end of his first term, the latest figures show premiums have instead increased an average of $2,200, even as more families have simultaneously moved to higher-deductible plans utilizing Health Savings Accounts—shifting even more costs of care to the individual on top of higher premiums.

Democratic Congressmen, facing continued opposition to their support of ObamaCare, have been quietly at work to eviscerate one of the law’s key components projected to hold costs down: the Independent Payment Advisory Board (IPAB). This unelected and unaccountable panel, composed of 15 experts appointed solely by the President—with no checks on its functioning by Congress or the courts—will be charged with determining what health care treatments are covered and at what price. When health spending exceeds any given year’s budget benchmark, the panel is charged with providing for a centralized fix.

The likelihood of the budget benchmark always being exceeded can be judged by experience with Medicare itself:

When Medicare was passed in 1965, for example, the federal government estimated it would cost $12 billion in 1990. Medicare actually cost $110 billion in 1990.

It is thus difficult to foresee the IPAB devising any solution for such shortfalls other than rationing, and perhaps the analogy of the IPAB to “death panels” was not so far-fetched after all. As a Venture Capitalist who backed the revolutionary development of angioplasty pointed out in Forbes, the IPAB is a recipe for the end of medical innovation. Thus, the House’s passage yesterday of a bill to repeal the IPAB.

Finally, the outcry over the imposition of a mandate that employers—including religious employers—cover 100% of the costs for their employee’s “birth control”—which includes sterilization and abortificants—clearly caught the administration by surprise. So far, the administration and the Department of Health and Human Services are standing firm, but the resulting loss of support by some of the bill’s formerly strong religious backers has been an unexpected blow.

With oral arguments being presented next week in the Supreme Court case regarding the “individual mandate” that could make or break ObamaCare, the White House is hoping the media blitz it has planned—including a “Prayerful Witness for Health Care” to encircle the Supreme Court from 11 am – noon on Monday; and a “Post-Argument Scrum” on Wednesday, at which legal scholars and ObamaCare advocates will tackle reporters outside the court house and in front of the United Methodist Building next door (headquarters for the 3-day pro-ObamaCare campaign)—can win over the court of public opinion that is so far eluding them.

Unfortunately, if the Supreme Court upholds the mandate and ObamaCare goes forward, ObamaCare at four will see a reality only further diverged from rosy predictions, and patients and taxpayers are likely to find themselves the ones needing prayer.

Mary L. G. Theroux is Chairman and Chief Executive of the Independent Institute.
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