By SHERMAN FREDERICK
Americans survived that Mayan end-of-time thingy pretty well. The jury’s still out, though, on our health-care system. We may look back on 2012 and say: That was the year the best health-care system in the world died.
In 2013, two big pieces of the Affordable Care Act kick in.
The first happens in October when state health insurance exchanges go live. Theoretically, Americans will then be able to browse through government-approved health-care plans and order one like a burger at a fast-food joint.
Will the choices be extensive, complete and affordable, or will America’s health care start down the rabbit hole of government mail delivery — less bang, more buck, and no Saturday delivery?
The second threshold comes in December of 2013. We should then have some clarity on the employer mandate portion of the law. Is it legal for government to compel companies of 50 or more employees to provide government-approved health care, or not. If it is, will private companies opt out of the system, pay a fine, and send workers into the government exchanges anyway?
No one knows. But we do know that the Obamacare road is already littered with unfulfilled promises and unintended consequences.
Remember the promise that we could keep our doctors?
Well, the official White House website now says: “The new rules permit you to choose any available participating primary care provider as your doctor,” Note how you can keep your doctor has changed to you can keep your “participating” doctor.
And that’s not the only variable. The question of whether employers will even provide government-approved health coverage is highly unsettled.
The original Congressional Budget Office guess at how many people would be involuntarily thrown into the exchanges was 3 million people by 2019. Now, the CBO says it will be 6 million by 2016. Another CBO report said it would be more like 20 million.
Bet on an even higher number. The system as currently built makes it a financial no-brainer for employers to opt out of the federal mandate. But either way, whether your doctor will be part of the government exchange or your employer’s new health care plan is a crapshoot, at best.
And, that’s not the only surprise coming.
The Affordable Care Act may not be so affordable. In 24 months the government projection for exchange subsidies has risen from $6,000 to $6,470 per person per year. That’s a 12 percent jolt. Does anyone really believe that this president and Congress can magically control health-care costs when they can’t even pass a budget — balanced or not?
Contrary to the Washington sophistry that changes the plain meaning of words, Medicare will be raided to pay for Obamacare. Funding for the ACA was sold saying the federal government would find “savings” (don’t say “cuts”) in Medicare spending.
Initially the “savings” would be about $500 billion from 2010-2019. Now, the CBO says the federal government has found $716 billion in “savings” in Medicare. This artful dodge robs Peter to pay Paul, masks responsible attention on Medicare solvency, and creates a new, big unfunded entitlement in Obamacare. This is your current federal government unchained.
And finally, the ACA was initially expected to generate $669 billion in additional revenue from 2010-2019. That’s been revised upward to $1.24 trillion between 2013-2022. About 2 million more uninsured Americans than estimated will pay the new health-care tax, according to the CBO.
That makes Obamacare a middle-class tax increase of enormous proportions.
Look, whether or not you think Obamacare was initially a good idea, we all can agree that we’re now building this plane as we fly it at 10,000 feet. I fear one day we’re going to look back on this period in history with a variation of the old joke about asking Mrs. Lincoln how she liked the play:
“Other than the outcome, Mrs. Lincoln, wasn’t your husband’s health care affordable?”
Sherman Frederick is former editor of the Tribune-Herald and former publisher of the Las Vegas Review-Journal.