PolitiFact offers a scorecard of predictions about the Affordable Care Act:
Predictions about the health care law were a dime a dozen back in 2010. Supporters contended that virtually everyone around the country would soon have access to affordable insurance. Opponents said the law would cost a fortune by adding to the national debt and killing jobs.
Actually, none of those things have happened.
A lot more people remain uninsured than supporters of the PPACA were predicting when the law was enacted and nobody knows whether the lower cost has anything to do with the PPACA or not.
My opinion on evaluating the results of the PPACA remain what it has been for some time: it’s too early to tell. Most of the provisions of the law weren’t implemented until 2014. Some won’t be implemented until years from now. Others will never be implemented.
I think that when the federal government starts phasing out its subsidization of the expansion of Medicaid in 2017 it will be telling. I don’t know how the states will respond but I do know that lots of states including Illinois don’t have the money to pay the full freight for the expansion.
From the article:
“I don’t think anyone anticipated when the law was written that states would have the opportunity to opt-out of the Medicaid expansion,” said Christine Eibner, senior economist at the Rand Corporation. “That’s a major departure from the law’s initial intent, and it leaves an estimated 4 million people in a coverage gap.”
Well, if that 4 million number is right, that’s the difference between the initial projection of uninsured by 2019 and the current one 2019. In fact, it’s more than the difference. So it seems like the initial projections were correct, if you take Rand’s number.
What’s more, note that the CATO mouthpiece interviewed basically shrugs his shoulders about the whole thing. Who knows? We could be in a death spiral or we could not be in one. Who knows anything? Just give the man his paycheck, that’s all that matters.
In the same vein Dick Cheney said a supposedly-outrageous thing when he said that Obama was the worst president ever because he used the race card when he was criticized, or something to that effect.
So basically: Obama, the worst president ever, because he’s not great with criticism. That’s what distinguishes him: his dislike of criticism. Not a deed or actions, just you know as a politician he doesn’t like criticism. Almost Nixonian, perhaps.
That this comes from a man who invaded a country for no reason and told someone to go fuck himself on the Senate floor is pretty much the story that describes half of America’s sensibilities.
“A lot more people remain uninsured than supporters of the PPACA were predicting when the law was enacted”
As the article notes, the CBO projected 12 million of this year and 11.7 million signed up.
“nobody knows whether the lower cost has anything to do with the PPACA or not.”
If we are keeping score, we need to remember that the prediction from the ACA opponents was that costs would “soar”. In fact, they have slowed down. How much of a factor they were in the slowdown is unclear. What is clear is that it did not make costs have a rapid increase.
I agree that it is too soon to tell, but as a work in progress I think it is not the failure predicted by the opposition. I would also repeat, again, that largely due to the ACA, for the first time in over 40 years in medicine in some form or another, I see people serious about cutting costs AND worrying about quality.
Steve
I’ll note that twelve million is far less that forty-five million, which was the number Obama promised would be great insured. And that forty-five million is likely to have upward pressure on it now that the borders have been dissolved.
Here are two recent articles that point out less than favorable stats on the PPACA:
CBO: Obamacare Hit Only 65 Percent of 2015 Coverage Target.
and
Rural Hospital Beset By Financial Problems, Struggle to Survive.
Finally, when it comes to healthcare costs, the future looks as if costs will continue to be problematic, despite the rhetoric of PPACA supporters who claim otherwise.
“I’ll note that twelve million is far less that forty-five million, which was the number Obama promised would be great insured.”
Citation please. Anyway, the predictions were that it would take until about 2020-2025 to have the max number signed up, and we always knew that it did not include illegals. Since it was not mandatory, it was also known that some percentage would not sign up. That is why the actual predictions were in the range of 25-30 million.
jan- Sigh. Your writer at National Review is wrong. Go read the paper he cites. It predicts, pages 9 and 10, 30 million by 2019, not 2015. I read this stuff nearly every day, so it was pretty clear he was wrong. Since you only dabble at this, let me recommend reading the primary source when it is actually cited.
We cover a critical access hospital. The problems precede the ACA. There is certainly a bit of truth in the assertion that some hospitals will face problems because their states chose to not participate in the Medicaid expansion, and it cuts Medicare funding from 101% of costs to 100% of costs. However, it should be pointed out that the GOP has been cutting Medicaid funding. If its plans had passed and we had the block funding they wanted, those hospitals would have faced even worse cuts. This is really a tough problem to solve. These hospitals cost a lot for what they provide and how many they cover, and whatever the program, a lot of their money is going to come from federal monies.
Finally, I don’t know a single left of center health care writer who claims costs won’t continue to be an issue. Straw man. Anyway, no one really knows what the high deductibles are going to do to costs. Conservatives have log advocated for consumer driven health care coverage, i.e. more skin in the game aka high deductibles. While it seems quite likely it will hold down increases in insurance costs, it is not clear what it will do to total spending, and coverage for that matter.
Steve
Steve, Trying to nail down consistent PPACA enrollment numbers is difficult to impossible. This is mainly because the administration has been less than consistent and transparent in providing said numbers from the very beginning, when this sad program rolled out. And, no matter how you present the numbers, the vast majority of people participating in the government-run program are doing so under either subsidies or being shoved into the expanded medicaid part of the ACA (many of whom don’t like being covered by medicaid, but have no other choice). “Sigh…..”
I agree that rural hospitals have always had a difficult time to maintain their services. The one in N. CA, providing minimum care for the community we live near, keeps it’s head above water through private donation events. There are also two air ambulance services which most people belong to, transporting people to larger hospitals for more serious problems. However, these rural community hospitals have been under even more duress since the implementation of the PPACA.
Yes, many (not only conservatives) do support a more consumer-driven health care — one having incentives for people to become better informed about medical options, which then tends to cultivate competitive pricing among medical providers. But, much like school choice is frowned upon, by those supporting a larger centralized government approach, so is choice becoming more limited in what is offered through the PPACA. Consequently, the cost controls, to those of us who are unsubsidized, are derived through sky-high deductibles, unless you want to pay sky-high premiums. As I commented before, anecdotally, I know a number of people who see no benefit from either of the above options, and also don’t qualify for subsidies or medicaid. Thus they are going without healthcare. This is progress?
“are derived through sky-high deductibles, unless you want to pay sky-high premiums. ” I wish you would go read. Consumer driven health care is exactly the same as high deductible insurance. It has nothing to do with consumers knowing more. If we get GOP reform, won’t happen, but if we do, that is what we will get. Catastrophic coverage is just high deductible insurance, another favorite of the GOP.
” However, these rural community hospitals have been under even more duress since the implementation of the PPACA.”
Only in states that did not participate in the Medicaid expansion. Plus, if you look at how these hospitals were doing before the ACA, you find that those states were almost universally already cutting state funds for them.
“Trying to nail down consistent PPACA enrollment numbers is difficult to impossible.”
Nope. Give up the conspiracy stuff. Besides, this pales compared with the outright lies and misrepresentations like the piece you quoted, and which nearly all conservatives believe. You cite articles but never even read them. You just make up what you want them to say.
Steve
” Catastrophic coverage is just high deductible insurance, another favorite of the GOP”
Catastrophic Coverage used to have premiums of $2500-$3500 for insurance assistance for serious incidents/illnesses. Now you don’t have those options because of the criteria set in place by the PPACA, driving premium costs much higher, while they cover items not even relevant to a policyholder’s needs. Earlier, well-liked catastrophic policies, gauged to the age, gender, and health necessities of a person, were oftentimes derided as sub par coverage — a snide way of saying the government knew best. Doesn’t that kind of condescending attitude ever bother or creep you out?
Furthermore, you tend to muddle the PPACA argument by bringing in the political divide — the dems vs the “GOP.” It’s much more complicated than that, and there are democrats and republicans, alike, who are equally frustrated and disenchanted with the ramifications of the PPACA
“Only in states that did not participate in the Medicaid expansion.”
…and, that was their choice. However, it was not their choice to have to deal with all the obligations of the highly flawed PPACA, which collided with even greater inadequate funding, over and above what the states might have been cutting for budgetary reasons.
” Give up the conspiracy stuff. “
It’s a good tactic of yours to chide a person, by degrading a POV to merely conspiracy themes. However, there has been a slew of written/verbal analysis critical as to how this law functions in real life, demonstrating the indecency of it’s origins, its’s selective and dishonest marketing of it’s coverage, all the way to the financial consequences of unverified subsidies, distortion of the language of the law, (now being looked at by SCOTUS) and so on. To simply dwell on your distaste for nasty conservatives does little to promote a healthy discussion of the pros and cons of the PPACA — the latter of which there are many!
*Catastrophic Coverage used to have premiums (meant to say “deductibles)
*driving premium costs much higher — again meant to say deductible rather than premium costs.