"What we've learned through the course of this program is that this is really not a sensible way for the healthcare system to be run."
That was Gary Cohen, director of the Department of Health and Human Services' Center for Consumer Information and Insurance Oversight, talking. He was specifically responding to the apparently surprising need to halt enrollments in a program designed as a temporary bridge for people with preexisting conditions who couldn't wait until the Affordable Care Act (a.k.a. Obamacare) fully kicks in next year. The program was allocated $5 billion, but some estimate it will take $40 billion to fund the effort.
Such surprises are becoming routine. The New York Times has reported that many small and mid-size firms may be opting out of Obamacare entirely. "The new healthcare law created powerful incentives for smaller employers to self-insure," Deborah J. Chollet of the Mathematica Policy Research told the paper. "This trend could destabilize small-group insurance markets and erode protections provided by the Affordable Care Act."
It turns out that Obamacare actually makes self-insurance less of a gamble because you can always throw workers on public exchanges without penalty. Naturally, the administration's response is to look for ways to tighten the ratchet and make self-insurance harder. It's a typical response. The shortcomings of a wildly ambitious law only justify more regulatory strong-arming.
As Yuval Levin of the Ethics and Public Policy Center notes, the NYT never paused to ask why it's OK that "a design flaw in the law somehow empowers" regulators to punish private employers. But this is typical of so much coverage of Obamacare. It is just taken for granted that thing must be made to work.
Although it's true that we collectively spent a lot of time shouting about Obamacare, we spent precious little time actually debating it. Most of the media covered the discussion as if it were a spectator sport, with the Democrats the hometown favorite. And much of the remainder seemed to assume that healthcare reporting amounted to explaining why Obamacare was a good idea. The facade of objectivity was often maintained by citing carefully crafted CBO projections that reflected political assumptions. Garbage in, garbage out.
Reality is teaching the propeller-heads a lesson. Despite President Obama promising that his plan would not add "one dime" to the deficit, the Government Accountability Office announced last week that it would more likely add 620,000,000,000,000 dimes (or $6.2 trillion) over 75 years.
Obama also promised that "if you like your healthcare plan, you can keep your healthcare plan." Estimates for how many Americans will lose their existing plans vary. The CBO says 5 million to 20 million. The consulting firm McKinsey & Co. says about 30% of employers will push workers onto the public system.
Even the AFL-CIO and the Teamsters have started to freak out over the gold-plated benefits many of their members will lose, thanks to the guy they helped reelect. Another irony: While the president rode to reelection hyping a mythical GOP "war on women," incentives to drop spouses from employee coverage under his plan will only increase, a particular concern for mothers with small kids. The good news is that if they keep their coverage, it will cover birth control pills.
Meanwhile, not just Taco Bell and Wendy's are demoting many full-time workers to part-time work. Some of Obama's core constituencies — universities and state governments — are cutting hours. For instance, Stark State College in Ohio sent a letter to faculty saying that "to avoid penalties under the Affordable Care Act ... employees with part-time or adjunct status will not be assigned more than an average of 29 hours per week."
Virtually all of these problems and many others were predicted by conservatives, but the media rolled their collective eyes in response. The Iraq war justifiably led to a lot of media soul-searching about how journalists were too credulous of the Bush administration's arguments. A similar discussion about how we got stuck in the Obamacare quagmire seems long overdue.