Constant pundit bombardment over 2014 ObamaCare predictions gets a bit overwhelming. But a few angles have yet to be explored in concert, which strike at the political heart of ObamaCare and will ultimately decide whether or not the law will survive in the future.
The law’s implementation has accomplished what no Republican candidate had been able to do, crater support for a law that was already deeply unpopular. Opposition to ObamaCare not only surged, but the intensity is firmly on the side of the right. And it is likely to get worse.
Americans who signed up for coverage on the exchanges may be in for an unpleasant surprise in 2014. Even if they have insurance, which is a serious concern due to inaccurate information transferred to insurers, but also they might have trouble getting the doctor to see them by mid-2014.
As Americans attempt to use their health coverage beginning January 1, experts are warning that ObamaCare will give them access to fewer doctors and hospitals. In fact, not only are experts warning the system will begin to resemble Medicaid in 2014 — the health care program for low-income Americans — but that Medicaid will offer less quality of coverage.
And Americans, much to their chagrin, will find out in 2014 that it was president’s and Democrats’ plan, all along. “Indeed, I think this will eventually be like Medicaid,” said Merrill Matthews, director of the Council for Affordable Health Insurance.
Matthews said the only way many insurers are going to be able to control costs is by “simply clamping down on the amount they are willing to pay,” and many doctors will start refusing to see patients. That will leave too many patients searching for too few doctors.
“About half of the physicians in many communities refuse to take Medicaid patients because the payment system is just too low,” said James Capretta, of the Ethics and Public Policy Center.
Doug Holtz-Eakin, former director of the Congressional Budget Office, says even some of the paid plans on the exchanges are designed with the same Medicaid-like flaws.
“If you look at something where you get a dollar by treating a private payer, you get about 70 cents out of Medicare for that same treatment, you get about 55 cents out of Medicaid for that,” adding, “you know, ObamCare started to look like Medicaid of the future, and in the Medicaid in the present, you can have the insurance but a doctor won’t see you.”
Even before ObamaCare passed, Medicaid already had this problem, and expanding that population while opening the door to lower payments for private insurance raises the need for rationing care.
“These networks are going to be jammed with people,” Robert Laszewski, president of Health Policy and Strategy Associates, said. “Far more than they’re treating now, and I don’t doubt that we’re going to have problems with access to these doctors. There just aren’t going to be enough of them.”
So, with the fundamental flaws of Medicaid already embedded in ObamaCare, the only question is whether the administration can sell it more effectively in 2014, or enroll enough poor Americans throughout the year that it seems inhumane to return to the “pre-health reform” era. As PeoplesPunditDaily.com previously reported, they are already well on their way to have Medicaid over-expansion enrollment.
“They have not done a very good job. That’s an understatement,” says Henry Aaron of the liberal-leaning Brookings Institution. “With time, I am sure they will get it right.”
But Aaron also outrageously characterized ObamaCare as a program that, “could become a positive for Democrats, an emblem of how limited government involvement in social areas can improve the lives of the American people.” I would question anyone who sees ObamaCare as an emblem of limited government involvement, particularly because it is involved so deeply in so many areas of Americans’ personal, deeply personal lives.
Douglas Holtz-Eakin, a health-policy expert who heads the center-right-leaning American Action Forum, said “the challenge will be filtering through what is pure election politics, what actually is a temporary start-up problem and what is a real policy flaw,” says Holtz-Eakin. “It’s going to be an interesting year. It is not going to be smooth.”
Aaron did concede challenges regarding how many people will enroll and how healthy or sick they are, likely premiums increases for 2015 that will be known in 2014, and knows it will be about “whether the politics of the situation give the administration the time they it need to fix this.”
However, in 2013 the administration repeatedly tried “to fix this” law through executive changes and delays, and if the administration cannot “fix” the fundamental problems written within the law’s design, it will “cast a very long, dark shadow over Democratic prospects in 2016,” he said.
“I think many Democrats assume that Social Security and Medicare and Medicaid as we know them are so entrenched in American life that they are untouchable. But Republicans have a plan to transform them.”
At the very least, despite his ill-placed optimism in government, Aaron admits the administration is not well positioned to “fix” whatever real policy flaws are hidden in plain site in ObamaCare before the election.
“As a betting person,” he said, “I think the right has the better prospects right now.”
And that is also my 2014 ObamaCare prediction in a nutshell. It will survive the year, but it will suffer fatal wounds. Of course, I could be wrong, and ObamaCare could survive indefinitely.
Sure, it survives if the American people “like Medicaid.”