When the 2,700-page Affordable Care Act stepped up to the plate and was passed two years ago, grand promises of increased coverage, lower costs and better outcomes that accompanied its passage all inspired a sense of hope. A few years removed from that excitement, deeper consideration of the act's long-term impact provides enough reason to strike it out and send it back to the bench.
Health insurance costs for families have risen considerably since the act's passage and show no signs of slowing. A recent Kaiser Foundation survey found that annual insurance premiums to cover a family of four through an employer increased by 9 percent, compared to just a 3 percent increase for families in 2010. PricewaterhouseCoopers' Health Research Institute expects this trend to continue, with a 7.5 percent increase projected for 2013 and beyond. Put simply, the administration's claim that the ACA solves the core structural problems that currently lead to higher costs within our health care system is unfounded. Strike one.
These costs, coupled with the mounds of regulations that await employers and insurance carriers in the near future, create an ominous cloud on the horizon for small businesses. Rather than making the types of structural reforms necessary to overhaul the entire system to increase coverage, Section 1513 of the ACA simply places the onus on employers of more than 50 workers to supply "adequate" coverage for their employees to avoid a costly tax penalty. The cost of this "employee mandate," which the Congressional Budget Office projects to cost businesses $52 billion from 2014-19, will ultimately be borne by workers in the form of lower wages and 700,000 fewer jobs. Given the already sad state of economic affairs, these are not effects that we can afford to shoulder. Strike two.
Finally, the massive Medicaid expansion that the ACA mandates for those up to 138 percent of the poverty level is well-intentioned, but ill-conceived. By increasing enrollment by one-third in what are already financially stressed joint federal-state programs, the ACA threatens to dismantle state budgets. Forcing states to increase payments to primary care providers only exacerbates this problem. Strike three.
All of these factors underscore the need to repeal the ACA and revisit health care reform with a view toward fundamentally restructuring the incentive structure of the system, which should not preclude the reapplication of some of the ACA's worthier ideas.
Heath Mayo '13 is a senior political science and economics concentrator from Whitehouse, Texas.
