With the debate over the repeal of Obamacare coming up, President Obama and his supporters in Congress are trying to calm the millions of Americans who strongly oppose the law by focusing only on its early sweeteners — including the right of 26-year-old “children” to stay on their parents’ insurance, the right to “free” preventive care, and the right of uninsured people with preexisting conditions to buy coverage.
While these provisions are all desirable, they are not without costs and consequences. It is therefore helpful to look at what other “rights” you will have under Obamacare when the full impact hits.
1. You will have the right to lose your job as employers struggle to comply with expensive mandates. According to labor economist Diana Furchtgott-Roth, those hit hardest will be younger, less-skilled workers. The cost of employing them will soar as employers are required to buy health insurance that may cost as much as a lower-wage person’s annual earnings.
High-tech workers will be hit as well. The $20 billion tax on medical-device companies, to take one example, will force companies to lay off researchers and curtail development of new products. And tens of thousands of insurance brokers will lose their livelihoods because of arbitrary regulations from Washington.
2. As a taxpayer, you will have the right to see the federal debt soar as Congress’s budget gimmicks face economic reality. According to former CBO director Doug Holtz-Eakin, Obamacare will cost nearly $1 trillion more than estimated as employers begin dropping health insurance and sending people to the new taxpayer-subsidized exchanges instead.
3. As a business owner, you will have the right to comply with the expensive new mandates in Obamacare or drop coverage and pay fines instead. You will have the right to keep the IRS informed about the coverage you are offering and its cost. And you will have the right to stop hiring and keep your business smaller than 50 people to escape Obamacare’s fines and mandates.
4. As an employee, you will have the right to lose the coverage you have now as you and 80 to 100 million people (according to McKinsey & Company analyst Alissa Meade) are switched to other coverage when Obamacare takes effect in 2014.
5. As a citizen, you will have the right to have the government decide what health insurance you must have and to either buy the expensive policy or pay a fine.
6. If you are a young person, you will have the right to pay higher premiums for mandatory health insurance to subsidize people who are older and sicker.
7. If you are a senior, you will have the right to see half a trillion dollars taken out of Medicare to pay for new health-insurance entitlements — a move allegedly designed to make Medicare stronger.
8. If you are in a Medicare Advantage plan, you and 7 million other seniors will have the right to go back into traditional Medicare and take your chances at finding a doctor who will see you.
9. If you are already on Medicaid, you will have the right to compete with millions more people trying to get appointments with doctors, especially specialists.
10. If you are one of the estimated 16 million people who will be added to the Medicaid rolls in 2014, you will have the right to wait in hospital emergency rooms for even routine care as the program swells to 87 million recipients by the end of the decade. (As many as 900,000 additional emergency room visits every year are expected — primarily by new enrollees in Medicaid — and from many of the 23 million people who will remain uninsured.)
11. If you are a doctor or nurse, you will have the right to receive lower Medicare payments while filling out mountains of new paperwork to satisfy government “quality reporting” requirements.
12. If you have child-only health insurance, you have the right to lose that coverage as more insurers exit the market. And you have the right to lose dependent coverage entirely as many employers decide it’s just too expensive to offer.
13. If you are an insurance company, you will have the right to figure out how you are going to continue to pay claims as government adds more expensive, mandatory benefits but caps premium increases at less than the cost of providing the coverage.
14. If you have a preexisting condition and are in a temporary high-risk pool, you and 8,000 others enrolled in the $5 billion program will have the right to pay high costs for your health insurance in the poorly designed program.
15. If you are a governor or state legislator, you will have the right to figure out what state services you will cut further — education? transportation? public safety? — to comply with the federal mandate that you expand Medicaid and set up the huge health-exchange bureaucracies. You also have the right to sue the federal government to protect your state’s rights.
And everyone will have the right to pay more for health insurance as the costs soar from what will surely be a heavily loaded list of benefits that your policy must cover.
Or you have the right to ask Congress to start over again and get health reform right.
Published on National Review Online: Critical Condition, Jan. 17, 2011.