The judicial decision to uphold all of the president’s health-care subsidies may be very disappointing, but the economics of Obamacare are far worse than whatever constitutional mistakes have been committed by the Supreme Court.
The economics of Obamacare are very bad. The law is inflicting broad damage on job creation and new-business formation. It ruins job incentives by making it pay more not to work, thereby intensifying a labor shortage that is holding back growth and in turn lowering incomes and spending.
Because of Obamacare, there’s an additional 0.9 percent Medicare tax on salaries and self-employment income, a 3.8 percent tax increase on capital gains and dividends, a cap on health-care flexible spending accounts, a higher threshold for itemized medical-expense deductions, and a stiff penalty on employer reimbursements for individual employee health-policy premiums.
Each of these tax hikes is anti-growth and anti-job.
A couple of examples.
First, there’s the problem of the 49ers and the 29ers. The business mandates and penalties imposed by Obamacare when small firms hire a 50th employee or ask for a 30-hour workweek are so high that firms are opting to hold employment to 49 and hours worked to 29. Lower employment and fewer hours worked are a double death knell for growth.
The BLS sheds light on this: Although part-time work has fallen during the recovery, from around 9 million to 7 million, it hovered around 4 million during the prior recovery. And part-time employment, which as a share of total employment peaked at around 20 percent in 2010 and has slipped to about 19 percent, hovered around 17 percent during most of the prior expansion. Obamacare?Everybody is complaining about the low labor-force participation rate and the equally stubborn reduction in the employment-to-population rate. But why are we surprised? Obamacare is effectively paying people not to work.
University of Chicago economist Casey Mulligan argues that Obamacare disincentives will reduce full-time equivalent workers by about 4 million principally because it phases out health-insurance subsidies as worker income increases. In other words, Obamacare is a tax on full-time work. After-tax, people working part time yield more disposable income than working full time.
Mulligan calculates that both explicit and implicit marginal tax rates within Obamacare may rise to near 50 percent as the law discourages those who attempt to climb the ladder of success. National prosperity and economic growth are again the victims.
And if all that weren’t bad enough, Obamacare enrollment is coming up short while the program is unable to sustain an adequate risk pool. Expert health-insurance analyst Robert Laszewski and the consulting firm Avalere find that exchanges are succeeding in enrolling low-income individuals, but are struggling to attract middle- and higher-income enrollees.
Meanwhile, it appears that the healthy Millennials are not buying enough Obamcare to finance the older and less healthy — especially those with preexisting conditions.
So if the sign-ups are lower and the risk pool is shorter and the hoped-for redistribution from young to old isn’t happening, insurance companies are forced to jack up premium rates. Again, not surprising. But the crisis is coming earlier than expected.
Laszewski reports that Texas Blue Cross wants a 20 percent rate hike, Maryland Blue Cross a 34 percent hike, Oregon’s biggest insurer Moda a 26 percent hike, and Blue Cross in Tennessee a 36 percent hike.
Not every state is experiencing this. But bad news has a way of spreading. Plus, insurance companies are increasingly worried that the government won’t back them through risk corridors or claim reinsurance or risk adjustments. So the dirty secret here is that a major taxpayer bailout is in the cards.
Look, government-run health insurance, or government-run anything, won’t work. Only free-market competition with free consumer choice will adequately set prices, premiums, and other costs. Obamcare mandates reduce freedom and raise costs.
Meanwhile, hospitals, doctors, and patients will suffer from lower reimbursements. Doctors are leaving in droves. The worst health care, Medicaid, which is completely government run, is exploding.
All this is why the system must be scrapped. And it won’t be missed. In the latest NBC/Wall Street Journal poll, 65 percent of Americans think Obamacare needs either modifications or a major overhaul, just 8 percent say it is working well, and 25 percent say it should be eliminated.
The Supreme Court decision is a minor part of the story. The big-picture question is: Can the U.S. not become Greece?