Hillary Clinton and Donald Trump are dominating the media. I saw this first hand when I worked in a newsroom over the summer: The coverage was non-stop!
They are not, however, the biggest story of the summer. Based on a steady stream of articles and studies, I’m convinced that if it weren’t for this highly extraordinary election, 2016 would be known as the summer the Affordable Care Act (ACA) started to crumble.
Aetna pulling out is especially bad.
Many predictions made before 2010 about the ACA have come true: Higher premiums, fewer choices, and reduced hours continue to paint a very ugly picture. These are the inevitable consequences of a one-size-fits-all system.
This summer, Aetna, UnitedHealth, Humana and many other insurers have pulled out of the public exchanges. The recent mass exodus is indicative of the distortions the ACA has caused.
These companies are suffering massive losses due to the ACA’s regulations on insurance policies for two main reasons. First, the individual mandate forces an expression of pent-up demand for health insurance, which explains why prescriptions have jumped. Second, the red tape and regulations are incredibly complicated and costly. Megan McArdle of Bloomberg put it best:
“[the ACA] was conceived and enacted as an extremely complicated system…Literally no one I ever interviewed — except, briefly, people on the political teams in charge of passing [the ACA] — said that this was a very good system.”
Originally, private insurance companies joined the public exchanges because they thought they would get a lot of guaranteed customers through the individual mandate to buy health insurance. Now, with all the losses, these insurance giants are no longer willing to play ball.
Many liberal outlets depict Aetna’s departure as being solely part of a vendetta against the administration for blocking their merger with Humana. This narrative is flawed because it ignores the enormous costs and losses Aetna, and other insurers, have incurred. This was clearly a business decision regardless of any personal politics.
Defenders of the ACA are very far from what they originally argued
The ACA is so off-base, its fiercest advocates no longer defend it for its original intentions.
First, it was originally promised the ACA would reduce premiums on average by $2500. Now its defenders point out that rates have risen less than expected.
Imagine that. It turns out the ACA did the exact opposite of what it was supposed to do, and yet we are still supposed to believe this is a sign of success.
Clearly the talking points on the ACA have shifted. Sometimes, though, the best strategy is silence. Take, for example, the issue of preserving patient’s options.
This summer, The White House quietly ran away from the selling point that the ACA keeps patient’s choices intact. Healthcare.gov took down their “How to keep your doctor” section. Likewise, The White House took down a fierce “reality check” section by a health official meant to defend the president’s promise.
The ACA advocates (aca-advocates?) have effectively thrown the promise of choice out the window. This is not surprising considering Politifact called President Obama’s promise to preserve choice 2013’s “Lie of the Year”.
When all else fails, defenders of the ACA point to the fact that the total count of uninsured Americans has gone down. Surely this is a positive development, right?
I should first mention that this downward trend in the uninsured is not true for Latinos, young people and those with low incomes according a study by the Commonwealth Fund. These are three of the primary demographics the ACA was supposed to help.
But let’s examine what’s really wrong with this argument. It is disingenuous to tout the reduction of uninsured people as an accomplishment. I could just as easily increase homeownership through a national mandate to buy a house. The individual mandate, in the aggregate, hurts people by forcing them to buy expensive health insurance.
Trump and Hillary will continue to dominate the headlines as we move towards November, which is to be expected. But remember, the whole point of electing a president is to run the government. And right now, our government is facing some problems.
The ACA’s crumbling is an incredibly important problem to be aware of. The ACA is one of the most consequential policies of the last eight years. Every day, it’s implementation is writing the history of our country’s politics. If we pay close attention, we can carry these lessons to evaluate future legislation.
Trump and Hillary may be exciting. We shouldn’t, however, miss the forest of national well-being because we are distracted by the trees of a dramatic election season.