• Quote: Why Obamacare will endure

    [S]ince 2010, [health care insurers and providers] have invested billions of dollars to overhaul their businesses, design new insurance plans and physician practices and develop better ways to monitor quality and control costs.

    Few industry leaders want to go back to a system that most had concluded was failing, as costs skyrocketed and the ranks of the uninsured swelled.

    Nor do they see much that is promising from the law’s Republican critics. The GOP has focused on repealing Obamacare, but has devoted less energy to developing a replacement.

    Healthcare industry officials generally view several GOP proposals, such as limiting coverage for the poor and scuttling new insurance marketplaces created by the law, as more damaging than helpful to the nation’s healthcare system.

    Noam Levey, LA Times


    • It is one of the great myths that Health Insurance has operated in some kind of free market. Health insurance has been heavily regulated and largely cartelized, at least for the last 70 years. The incumbents like it that way because it protects profits. The ACA goes one better and has the government almost guarantee a profit for the incumbents as long as they keep playing by the new rules. So no, I am not surprised that the major carriers are cool with the ACA.

      • Almost entirely by the states. As even those on the right concede, states have the right to regulate almost anything they want (except guns since they are sacred). Any state, red or blue, could have long ago gone to a pure market system. None has done so. They all regulate. They all have mandates.


    • Like abortion, gay marriage, and prayer in school Obamacare is nothing more than a fund-raising mechanism for the Republican party. Does anyone doubt that Obamacare would still be at least 80-90% intact when Republicans are in control? The only thing they will do is call the mandate penalties tax incentives.

      • Moreover, within the lifetimes of most of us, I suspect that talk of repealing the ACA will draw a reaction similar to trying to outlaw firearms altogether — political suicide.

    • The end of Obama care would not mean a return to what
      existed before. As the article pointed out the insurance companies
      have made changes and these changes are not going away. Let’s hope
      we don’t find out what the new health insurance system will look
      like without the ACA.

    • Gillian has it right.

      Once the individual mandate and public exchanges and Medicaid expansion and the employer mandate are in place for a year or two, the “statu quo ante” will be destroyed. Pre-PPACA coverage could not be resurrected even if someone wanted that system.

      Further, right now we see the changes by insurance companies and health care providers. You think you’ve seen a lot of change and upheaval. Just wait. The other shoe will soon drop once employers spring into action – most of them are sitting on the sidelines today. They are in what I call a “comply as you go” mode, making “once and done”, “compliance-oriented” changes – kids up to age 26, eliminating lifetime maximums, no pre-ex, etc. However, employers are much more dynamic in their responses to cost pressures, fiscal opportunities and risk challenges. They are NOT paternalistic, but risk averse given the massive increase in regulatory activity. Obtaining tax preferred coverage while avoiding excise tax penalties, all the while managing migration and costs, will become an art form.

      So, expect the estimates of 80MM – 90MM losing pre-PPACA employer-sponsored coverage in favor of a post-PPACA design to be a significant UNDER estimate. That is, I predict that less than 20MM Americans will have a “grandfathered”, employer-sponsored health plan by 12/31/2015.

      You policy wonks (and the D’s and the Obama Administration) will blame the massive level of change in coverage on the insurance companies and corporations. It will go something like “Oh, they could have kept the coverage in place” without remembering to mention the increased cost. And, you will continue to castigate any employer that speaks up – that puts price tags on the various PPACA mandates, explains the need for workers to pay more and transparently assigns those new costs to employees (the supposed beneficiaries of the patient protections and market reforms).

      There is no opportunity to put the toothpaste back into the tube here.