By now, most people have concluded that the Patient Protection and Affordable Care Act (ACA, Obamacare) does not reduce the cost of healthcare for the majority of Americans, and certainly does not protect them. Healthcare costs - both insurance and out of pocket expenses - have more than doubled for many and will continue to increase. What is difficult and confusing to most of us is attempting to understand how this all fits together and why.
Just a few months ago, the Obama administration had serious concerns regarding formation of state health insurance exchanges. This vital component of the ACA is necessary to move it forward, yet only 17 states agreed to build exchanges. The federal government pivoted and approached this problem from a different direction. They offered to pick up the tab on an expansion of Medicaid for 2 years, and then 90% thereafter… forever. That was enticing enough to persuade eight GOP Governors, who previously wanted no part of the health insurance exchanges, to accept this “gift”. They viewed this as separate from Obamacare, but is it really? Unfortunately, it is not. It is all tied together.
To understand what is happening, it is necessary to examine this issue historically. For over a century, Progressives have unsuccessfully tried to pass bills in Congress which would establish single payer, government run healthcare. For them, this has always been the “holy grail”. Realizing that success could only be achieved incrementally, they settled for passage of Medicare in 1965. By controlling the healthcare of senior citizens, and then the poor through Medicaid, the federal government gained a foothold into healthcare that for decades they had sought. Over the next 50 years, our Federal government slowly assumed a greater role in healthcare through regulation and legislation. Then, in 2008, the most progressive president in history was elected and the goal of a single payer, government run system was closer than ever.
To make the leap from where we are today to a single payer system, things have to get so bad that the federal government will be left with no “viable alternative” other than stepping in to rescue the American health care “system”. The myriad and still not fully understood regulations in the ACA makes this outcome inevitable.
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