Tevi Troy examines for Commentary magazine readers the prospects for repeal, replacement, and/or reform of the Affordable Care Act once Barack Obama leaves the White House.
Republicans have long been accused of not having alternatives to the ACA, but in truth, if anything, Republicans and conservatives have designed and proposed too many plans to replace ObamaCare. This makes it extremely difficult for Republicans to unite behind a single plan. Fortunately, the primary battles will help select a standard-bearer who can champion and rally support for a single plan that the party can finally call its own.
The candidates, and eventually the new president, will have to properly define the ObamaCare problem. In designing the Affordable Care Act, the Obama administration tried to lasso the moon—to bend the cost curve down while providing universal insurance coverage at the same time. In doing so, the president highlighted the number of people who were uninsured at any point throughout the year, a figure that ranged between 30 million and 46 million.
The law failed to solve either problem. Costs have continued to rise, and even with the increase in the number of people covered, there are and will remain tens of millions of people in the uncovered category. According to the Congressional Budget Office (CBO), there are 35 million people currently uncovered. Even in 2025, more than a decade after its implementation, there will still be 27 million uninsured Americans. The ACA, therefore, has not solved the problem of insuring all Americans at some point in the course of a year. By the standards of the legislation’s intent, it has been, and it will remain, a failure.
The ACA has also failed in its secondary objective: It has not solved the problem of rising costs. Indeed, it has probably made things more costly for both the insured and the federal budget. A recent analysis by Health Pocket found that the ACA plans submitted across 45 states were an average of 14 percent more expensive for the upcoming 2016 year than they were in 2015. And according to the University of Minnesota’s Stephen Parente, the average family plan could cost 61 percent more in 2023 than it did in 2015.
The sales job Obama did on the Affordable Care Act compelled him to claim it would be the comprehensive solution to America’s health-care ills, and his immodest approach unsurprisingly yielded an immodest and unwieldy result. Providing a path to a positive and more tailored solution is therefore essential to replacing or reforming the legislation.
Such a path requires reframing the problems that serious health-care legislation must solve.
