Donald Trump recently asserted on Truth Social “Obamacare sucks!!!” He’s right. The Affordable Care Act (ObamaCare) has failed to achieve any of President Barack Obama’s vaunted promises. Democrats know it, and yet they complain about the U.S. health care system’s problems and costs without ever acknowledging that’s ObamaCare. As we approach the law’s 10-year anniversary — it passed in 2010, but most insurance reforms started in 2014 — let’s revisit some of its failed promises.
Perhaps Obama’s greatest whopper was “If you like your health care plan, you can keep it.” That claim by the president earned him Politifact’s 2013 “Lie of the Year.” Millions of Americans had individual (i.e., non-group) health coverage they liked, but lost it almost immediately — including my wife. Others after a year or two. And the reason was obvious. ObamaCare mandated new or expanded coverages that weren’t part of most individual health plans, so those plans weren’t qualified under the law’s mandate to have insurance.
Did those mandates make health coverage more comprehensive? Yes, but they also made it much more expensive, which brings us to ObamaCare’s second major failure.
Remember when Obama asserted that a family’s annual premium would drop by $2,500? In fact, you were lucky if your family premium went up by ONLY $2,500 over the next few years. Again, the reason was obvious.
No one would believe a politician who claimed that new government-mandated regulations, features and amenities on new cars would lower car prices. The new features and amenities might be nice, they might even make a car safer, but they would increase a car’s cost. And that increase would price some people out of the market.
The same is true of health insurance. Government insurance mandates come with a cost. And a lot of mandates come with a big cost. Recent news reports say employers will see their biggest premium increase in a decade in 2024, even after insurers have made multiple changes to their plans over the last decade to try and keep premiums down.
We’ve all heard about “shrinkflation,” where companies during inflationary times reduce the size or amount of their products in an effort to minimize price increases. Health insurers did the same under ObamaCare. They raised deductibles significantly. They increased co-pays for doctors’ visits and prescription drugs. And many insurers shifted to co-insurance for expensive drugs, meaning the patient might pay hundreds of dollars out of pocket for a prescription that once cost a $25 or $50 co-pay.
ObamaCare defenders might point to the low premiums paid by most individuals with coverage through the ObamaCare exchange. But that’s only because taxpayers, not the insured, are subsidizing most of their premium.
Defenders might also claim the number of uninsured has dropped. Yes, but only because the law also greatly expanded Medicaid coverage for low-income individuals.
Medicaid covered 17.8 percent of the population in 2013, according to the Kaiser Family Foundation, but 21.2 percent in 2022. Employer coverage was about the same in both years.
What about ObamaCare’s health insurance exchanges that were going to provide individuals buying their own coverage with lots of very affordable health plan options?
In 2013, the year before ObamaCare’s health insurance exchanges began, 5.3 percent of the population bought individual (non-group) coverage, according to Kaiser. By 2022, it was 6.3 percent — a one percentage point increase. And the only reason the number is that high is taxpayers subsidize the coverage.
The irony is that Democrats thought ObamaCare’s health insurance exchanges were the genius idea in the Affordable Care Act that would remake the health insurance system and move the country to near universal coverage. As of 2022, there were still some 26 million uninsured.
ObamaCare imposed fewer tweaks on employer coverage, where nearly half the population gets its coverage. So it still functions reasonably well. But even there premiums have exploded, with the average family premium costing $24,000. And that’s the average, many employer plans cost much more.
Democrats’ efforts to remake health insurance through ObamaCare has only made many of the problems worse. Insurance is much more expensive, millions lost coverage they wanted to keep, and millions are still uninsured. While Democrats, like Trump, regularly complain that the health insurance system sucks, they refuse to acknowledge that system is the ObamaCare law they praised and voted for.
Merrill Matthews is a resident scholar with the Institute for Policy Innovation in Dallas, Texas. Follow him on X@MerrillMatthews.