The Corner

Viability?

In response to Flashback

Rich reports that Vox – even Vox​! — concedes: “Obamacare is going through a major test of its viability.”

This is sincerely not intended as petty or snarky or partisan, but I don’t see how this is a test of the program’s viability rather than a confirmation of its non-viability, at least in regards to the 46 states in which Aetna will not offer plans through it. It previously had offered those ACA plans in just 15 states. Dozens of other insurers also are fleeing Obamacare, for obvious reasons. 

As Vox puts it:

Aetna follows United and about a dozen other insurers who have, in recent months, decided to quit Obamacare or significantly scale back participation. These decisions will leave customers with fewer choices than ever before.

Yes, we told you so. I’d say I hate to say it, but I don’t. 

At the time of the Obamacare debate, conservatives (including your favorite correspondent) argued that the popular parts of the plan (subsidies and coverage rules that function as subsidies) would survive, while the unpopular bits (such as the so-called Cadillac tax) would not. That’s about what’s happening. We also predicted that there would be pressure for consolidation among insurers, hospitals, and medical practices (check), that many firms would find the artificial markets created by ACA unworkable (check) and that the response to this would be a call for a “public option” — here effectively meaning putting the whole country on Medicaid by default — as markets designed to fail failed. And that is what Hillary Rodham Clinton is calling for. 

Of course Obamacare is not viable. That’s why the Obama administration never has even attempted to implement it in its entirety. Some of us predicted just that at the time of the bill’s passage. 

Unfortunately, Republicans have decided to inflict another President Clinton on the country rather than a President Cruz, Rubio, Walker, Jindal, etc., which means that root-and-branch repeal of the law is probably off the table for a decade or so. But the program is unpopular, and it is going to get more unpopular as it comes more and more into force, which means that effectively gutting it and replacing it with a market-based alternative might not be too hard so long as the bill doesn’t say “repeal” at the top. 

That assumes that the Republican congressional majorities survive the Trump train wreck. Let’s hope they do.

 

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