President Obama’s legacy of transforming access to healthcare is on the precipice of coming undone no matter who replaces him in the White House.
The next penalty phase for not signing up for the controversial program, together with the actual cost to those covered, continue to defy the promises made when it all started.
This will result in outcomes ranging from major changes to its complete elimination.
A New York Times story last week highlighted just how much trouble the Affordable Care Act is facing.
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The consequence could be to start all over again in the effort to reform how Americans get what they need and want.
The fundamental reality underpinning the success of Obamacare is that it depends on many millions of healthy individuals who won’t be filing many claims nevertheless signing up and paying the required premiums.
Realizing that necessity, the president intended to force health insurance on everyone and hit those who didn’t comply in the pocketbook through penalties exacted by the IRS.
The effect of that scheme, as described in the Times report, is simply more confiscated revenue for the government while, according to the Obama administration, 10.5 million people who are eligible for coverage under the new law remain uninsured.
Apparently a great many have figured out that more than doubling the penalty in 2016 for not getting enrolled still remains far cheaper than buying insurance they either don’t want or can’t afford.
One 61-year-old told the Times she was leaning toward going uninsured because the penalty was just a little more than 10 percent of what the premiums and deductibles would be if she bought the coverage she would need.
“If something catastrophic happens,” she said, “I feel like it’s better just to die.”
Such experiences, together with the latest polling by CBS/NY Times finding that just four in 10 Americans approve of the law, provide all the motivation for every presidential candidate in both parties promising to fix Obama’s mistakes.
On the Republican side, every one of the contenders say they will repeal his signature achievement and either replace it with something better or just let the free market prevail.
If somehow Bernie Sanders winds up as president, he says he’s going to put everybody under Medicare — even though various reports have found that to be financially unsustainable.
His plan to pay for it fits nicely into the self-described socialist’s passion for redistribution of the country’s wealth.
So that leaves Hillary Clinton, who remains the prohibitive favorite to win the Democratic nomination — unless her lies newly emphasized in the latest Benghazi revelations finally catch up with her.
While she continues to declare her defense of the ACA, she has acknowledged “glitches,” including how devastating it is to small businesses.
That dilemma has produced a proliferation of part-time jobs for which employers don’t have to provide healthcare benefits.
Here’s how her campaign website sums up her plan:
“Transform our health care system to reward value and quality. Hillary is committed to building on delivery system reforms in the Affordable Care Act that improve value and quality care for Americans.”
Note the words transform and reforms, which leave open a return to the failed Hillarycare initiatives from her husband’s administration and the certainty that Obama’s achievement will fall somewhere short of historic.
In any event, the unpopular program is going to either go away entirely or be rewritten as the next phase of universal healthcare in the hands of a government that has yet to demonstrate it knows what it is doing.
Richard Greene is a former Arlington mayor and served as an appointee of President George W. Bush as regional administrator for the Environmental Protection Agency.