Masked by subsidies, the one-size-fits-all system has pushed up prices across the broader medical insurance market, say experts.
The government shutdown might be over, but the political and financial problems that dog Obamacare haven’t gone away.
Congress is now debating a second extension of the temporary tax credits that have shielded Obamacare users from rising costs for five years. Without the subsidies, Democrats say millions of Americans will be priced out of the health insurance market at the stroke of midnight on New Year’s Eve.
President Donald Trump and other Republicans don’t want an extension; they want a transformational change that eliminates what they say are the unworkable policies and perverse incentives that have plagued the program from the beginning.
It isn’t just Republicans who say Obamacare went awry. Many experts and even some Democrats recognize that while the program did make health coverage more affordable for 24 million Americans at one point, it has essentially backfired.
Here’s how they think Obamacare went off course, how it might be overhauled, and how it upended the wider health insurance market.
Failed Aims
The Affordable Care Act aimed to make health insurance affordable for everyone and lower health care costs across the board.
“The reality of the [Affordable Care Act] could not be more different,” Douglas Holtz-Eakin, president of the think tank American Action Forum, said in written comments to a Senate committee on Nov. 19.
Republicans have said the system was poorly designed from its beginning in 2014. Now, some Democrats agree it has not been successful.
Sen. Peter Welch (D-Vt.) said as much in a Nov. 6 speech imploring colleagues to extend the temporary tax credits, which expire in December.
“I owe you an answer on why it is I am standing here today asking to extend something that was temporary,” Welch said. “Here is the reason: We did fail to bring down the cost of health care.”
Sen. Bill Cassidy (R-La.) said on Nov. 19: “I think there’s remarkable agreement between Democrats and Republicans. Obamacare failed to give access to all Americans to health care, and Obamacare failed to control health care costs.”
