Until a year ago, Obamacare's fans could continue to pretend the emperor wasn't naked. Their scheme to control the behavior of their fellow citizens was all good intention.
But now, a year has passed since Congress repealed the individual mandate to purchase health insurance. And the elapsed time has revealed that Obamacare's least-popular element was not nearly as important to the law's functioning as its proponents had represented.
This complicates the recent ruling in Texas. A federal judge there struck down Obamacare on the grounds that the law supposedly cannot survive without the now-repealed mandate and its financial penalty against the uninsured. Without such a mandate, the argument went, the young and healthy will fail to purchase insurance, leaving only the sick and old in an increasingly unsustainable and expensive insurance pool.
At the time of the Obamacare debate, the core function of the individual mandate was to please the insurers, whose lobbyists (and whose future lobbyists, working for Democratic members of Congress) were heavily involved in drafting the law. If they were going to be put on the hook for extra risk in the form of sicker and currently uninsured patients, they wanted a captive market in return. This was part of the framework that the insurance lobby unveiled two weeks after former President Barack Obama's election as their opening bid.
America's Health Insurance Plans, the umbrella lobby for the industry, proposed that "health plans participating in the individual health insurance market would be required to offer coverage to all applicants as part of a universal participation plan in which all individuals were required to maintain health insurance."
But the last year has shown that the individual mandate wasn't really affecting individual market consumers' behavior that much. What were affecting it, and still are, are the unreasonably high premiums and shoddy, high-deductible coverage that go along with Obamacare plans.
Obamacare has been a failure. The closest it came to success was that it opened up Medicaid to able-bodied, childless nonworkers. Their presence on the rolls technically lowers the uninsured rate, but in doing so, it also makes health care less available for the poor families with children whom Medicaid was designed to help.
For the rest of America's citizens and lawful residents, especially those who pay for their own insurance but don't get it through work, Obamacare has been very unkind. Each year, it leaves fewer and more expensive options for health insurance than the year before. Between its funneling of the most expensive patients into the individual market, its ban on health underwriting and its onerous minimum benefit requirements, Obamacare has stuck most middle-income workers with a far worse deal than they had before 2010.
Far be it from us to praise Obamacare, which continues to plod along with poor-quality choices and ever-worsening value for insurance customers' money. But whatever the fate of the ruling striking down Obamacare, the debate over it only reinforces what we've known since before Obamacare was rammed through Congress: It was not a well-made law. There was no expertise involved in crafting it. Rather, it was a combined wish list from liberals and the health care and health insurance industries.
We only add for the record that those voting on it had no clue what they were supporting and that most of them neither read nor understood it. That's why it was always an incoherent measure, doomed from the beginning to provide a suboptimal outcome for everyone. And whether this current ruling stands up on appeal or not, Congress has to do something to fix all the problems that existed before Obamacare, which it mostly made worse.
REPRINTED FROM THE COLORADO SPRINGS GAZETTE