Did ObamaCare ‘Work’?

ZeroHedge, Dec 07, 2023 – Via Political Calculations blog, | Excerpts:

The Affordable Care Act was signed into law in 2010. It was slowly implemented, going into full effect in 2014. One of the main goals of the law was to make health insurance more affordable for Americans, but has it worked?

One way to answer that question is to see how much Americans are paying for health insurance since the ACA became law and to compare that how much American households would otherwise have paid if the preceding trend for health insurance costs remained in place.

We can make comparison using data from the U.S. Census Bureau’s annual Consumer Expenditure (CEX) Survey. The CEX has reported how much an average “consumer unit”, which roughly corresponds to an American household, has paid for health insurance in each year from 1984 through 2022. It compares those data points with the trend based on the actual expenditures for health insurance from 2000 through 2010. Here’s the chart:

Compared to the pre-Affordable Care Act trend from 2000 through 2010, Americans household consumers paid 35% more on average for health insurance in 2022 than they would otherwise have paid based on the trend for these costs from 2000 through 2010.

How does that compare with the household consumers’ other major health care expenditures? The chart is adapted from an older version and narrows in on the period from 2008 through 2022 to track the change in the average expenditures per American consumer unit for several health care expenditure categories. These categories include health insurance, medical services, drugs, and medical supplies.

Through 2022, what American household consumers pay for drugs and medical supplies has changed very little, with medical supplies within $95 and drugs within $133 of their cost in 2008.

Expenditures for medical services has seen more growth over time. In 2013, the year before the Affordable Care Act took full effect, Americans paid just $69 more for medical services than they did in 2008. By 2019, that increased to $257, which then dipped to $137 in the pandemic year of 2020. What American consumer households pay for medical services has risen rapidly since, as of 2022 they reached $457 more than they paid in 2008.

But what Americans pay for health insurance has relentlessly risen in all but one year (2017). In 2013, just before the Affordable Care Act became fully operational, Americans paid $576 more for health insurance than they did in 2008. That jumped immediately to $1,215 in 2014, and has since risen to be $2,190 more than what American consumer units paid for health insurance in 2008.

2022 is the most recent year for which we have figures available. The Census Bureau will collect the data for 2023 in March 2024 and will crunch the numbers for several months before reporting it all sometime in September 2024.

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The U.S. Health Care Freedom Plan, an integral component of The Leviticus 25 Plan, will restore citizen-centered health care and summarily reduce ‘annual expenditure for health insurance’ by eliminating bureaucratic bloat, unfriendly and complicated medical access pathways, cumbersome, drawn-out claims processing, and rapidly shrinking reimbursements for physicians, pharmacists, and other health practitioners.

The U.S. Health Care Freedom Plan offers a powerful new access strategy for patients receiving medical and pharmaceutical services, home medical equipment, and home care services.

The Plan grants citizens the freedom to pay directly, in person, for their week-to-week health care purchases. It cuts out layers of bureaucracy and middlemen … simplifies access to health care and restores genuine ‘patient-provider’ relationships.

The U.S. Health Care Freedom Plan is the only comprehensive, citizen-centered health care plan in America.  It ‘resets’ the health care industry to present a clean, efficient and responsible system.  Most importantly, this plan restores individual citizen-centered health care for all participating Americans.

The U.S. Health Care Freedom Plan is available to each and every U.S. citizen – with no coverage mandates. Each U.S. citizen who wishes to participate will be granted a full and complete exemption from the ACA.

Each participating U.S. citizen shall receive a credit extension, through a special Federal Reserve / U.S. Treasury Citizens Credit Facility of $30,000, electronically deposited into a Medical Savings Account (MSA) – for direct allocation toward family health care needs.

Private insurance – Families shall be allowed to enroll in high-deductible major medical plans, that include basic, ‘no frills’ medical plans which best suit their individual needs and desires. These streamlined plans would lower premium costs for employees and employers, encouraging employers to cost-share savings with employees through incentive-based employer MSA contributions.

Those with extraordinary medical issues may be included in a high-risk category, with such plans being eligible for a government subsidy (similar to current Medicare Advantage).

Federal / state programs – Individuals enrolled in Medicare / Medicaid / VA / TRICARE / FEHB programs would maintain their covered status, with an annual deductible of $6,000 per year per enrolled family member, for a period of five years for those benefits. The dedicated MSA funds would fully fund the offset for the higher ($6,000) deductible feature for that five-year period. MSA funds could also be used to pay Medicare supplement premiums and other potential co-pay obligations.

Where health care services paid by patients directly with MSA funds, providers would not be bound by federal / state rules pertaining to Electronic Medical Records (EMRs), and other unnecessary administrative burdens.

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The Leviticus 25 Plan activation period is slated for the 5-year period beginning in 2026 and ending in 2030.

The Leviticus 25 Plan – Each participating U.S. citizen will receive a $60,000 deposit into a Family Account (FA) and a $35,000 deposit into a Medical Savings Account (MSA).

Qualification: All U.S. citizens residing in the United States are eligible to participate, contingent upon meeting qualification standards and agreement to specified recapture provisions. Participants (other than ‘custody account’ applicants) must prove stable credit history, stable job history, no recent drug/felony convictions.

These general recapture provisions include:

• Waiving all federal income tax refunds for a period of 5 years.
• Waiving benefits from income security programs, select benefits from means-tested welfare programs, SSI, and SSDI for a period of 5 years.
• Enrollees in the Medicare, Medicaid, VA Healthcare system, Federal Employees Health Benefits (FEHB), and TRICARE will be subject to a $7,000 deductible for primary care and outpatient services annually for a period of 5 years. (See full plan for more details)

The Leviticus 25 Plan generates $37.303 billion federal budget surpluses annually during each of its first five years of activation (2027-2031), and pays for itself entirely over a 10-15 year period.

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The Leviticus 25 Plan is a dynamic economic initiative providing direct liquidity benefits for American families, while at the same time scaling back the role of government in managing and controlling the affairs of citizens.  It is a comprehensive plan with long-term economic and social benefits for citizens and government.

The inspiration for this plan is based upon Biblical principles set forth in the Book of Leviticus, principles tendering direct economic liberties to the people.

The Leviticus 25 Plan – An Economic Acceleration Plan for America

$95,000 per U.S. citizen – Leviticus 25 Plan 2026 (34114 downloads )

WSJ: The Inflation Reduction Act Comes for Medicare

It will cut benefits and increase premiums, upsetting millions of elderly voters.

By Casey B. Mulligan and Tomas J. Philipson

Nov. 21, 2022 – Excerpt:

President Biden has accused Republicans of scheming to cut Medicare. In fact it is his signature legislation, the Inflation Reduction Act, that will lead to benefit cuts and premium increases for seniors. Medicare’s popular drug-coverage program is headed for a painful amputation.

The private plans participating in Medicare’s prescription-drug program, known as Part D, currently draw on three sources of revenue to finance prescriptions: out-of-pocket payments from patients, premium payments made by plan members, and subsidies from the federal government. In 2025, under the Inflation Reduction Act, both government subsidies and out-of-pocket payments by patients are scheduled to be cut sharply. The difference will have to be made up by premiums. But the statute inhibits this third revenue source, which is also subsidized, from increasing more than 6%. That’s hardly enough to cover inflation, let alone compensate for the other two revenue losses.

We estimate that beginning in 2025, plan subsidies—specifically, the reinsurance subsidies for the beneficiaries with the most drug spending—will be cut $30 billion, out of revenue that currently totals about $110 billion. With $30 billion less to finance prescription benefits, something will have to give. Plans currently have far too little profit to span the chasm that the Inflation Reduction Act opens between expenses and revenue.

Existing plans have room to cut benefits, although the original Part D statute limits their ability to do so. As plans are under no obligation to take a loss, their other choice is to exit the market, which from the patient’s perspective means that all the benefits disappear. In essence, the Inflation Reduction Act statute may prohibit Part D plans from being economically viable, even if it doesn’t explicitly ban them.

We see a last resort. Seniors might find drug coverage in Medicare Part C even as the Biden administration unwittingly amputates stand-alone drug plans from the Medicare program. These plans, known as Medicare Advantage, cover drugs, hospitalization and physician visits. They will also be losing the same two drug-revenue sources, but the Inflation Reduction Act gives them room to compensate with higher premiums, reduced drug benefits (with fewer drugs covered and more constraints on accepted claims), or cuts to nondrug benefits such as dental or mental-health coverage. They will likely do all three, which will be undesirable for seniors but at least be economically viable. The best part of the last resort? The plans won’t go away.

Roughly half of Medicare beneficiaries currently have traditional Medicare coverage rather than Medicare Advantage plans. These are the beneficiaries relying on stand-alone Part D drug plans, which are the ones that may be run out of business by the Inflation Reduction Act. Traditional Medicare members face a difficult choice in 2025: Either take drastic cuts in drug coverage, or switch to Medicare Advantage plans that cover prescriptions but may not cover the hospitals and doctors who are currently providing them care.

Welcome to the fiscal and regulatory nightmare known as government-provided health care, where those writing the rules don’t understand the consequences of what they do. Democrats hate that Medicare Advantage has been available as a pseudo-private alternative to original Medicare’s single-payer arrangement. Yet they have (unwittingly?) passed a law that so thoroughly disrupts traditional Medicare as to render it the worst of the Medicare options.

From a political perspective, Democrats couldn’t have scheduled Medicare’s amputation for a worse time. With Congress so evenly divided, a short-term legislative fix may be impossible. By September 2024, the presidential campaign will be in high gear at the same time that beneficiaries begin to consider their 2025 Medicare enrollments. That’s when the Inflation Reduction Act will thoroughly upset tens of millions of elderly voters, all while the authors of the statute ask the country to vote for their presidential nominee. By then, America will have no doubt which party is cutting Medicare.

Mr. Mulligan, an economics professor at the University of Chicago and a fellow with the Committee to Unleash Prosperity, was chief economist for the White House Council of Economic Advisers, 2018-19. Mr. Philipson, an economist at the University of Chicago, was a member of the White House Council of Economic Advisers, 2017-20, and its acting chairman, 2019-20.

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It is time to shift from ‘government-provided health care’ to ‘citizen-centered health care.’

The Leviticus 25 Plan – An Economic Acceleration Plan for America

$95,000 per U.S. citizen – Leviticus 25 Plan 2026 (33715 downloads )

America needs a comprehensive plan to de-centralize health care. And there is just such a plan, loaded up and ready to launch…

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Insurers Request Huge Obamacare Rate Hikes, Many Over 20%

ZeroHedge, Jul 20, 2025 – Authored by Mike Shedlock via MishTalk.com,

Excerpt:

Medical care costs are surging already. A big leap is coming.

Health Care Shock Coming

The Wall Street Journal reports Obamacare Insurers Seek Double-Digit Premium Hikes Next Year

If you buy your own health insurance, you are probably going to pay more next year—a lot more.

Insurers are seeking hefty 2026 rate increases for Affordable Care Act marketplace plans, the coverage known as Obamacare. Blue Cross & Blue Shield of Illinois wants a 27% hike, while its sister Blue Cross plan in Texas is asking for 21%. The largest ACA plans in Washington state, Georgia and Rhode Island are all looking for premiums to surge more than 20%.

The companies say the big increases are needed because of higher healthcare costs and changing federal policy, including cuts to subsidies that help consumers pay for plans. The higher premiums would come after years of enrollment growth and mostly single-digit rate increases in the Obamacare market, where individuals and families buy insurance for themselves. About 24 million people have ACA plans.

At the request of The Wall Street Journal, the health-research nonprofit KFF analyzed the rate requests for the largest ACA plans by enrollment in 17 states where the insurers’ filings have already become public, as well as the District of Columbia. They showed that some of the biggest national ACA players, including Centene and Elevance Health, are seeking double-digit increases in several states. The Blue Cross & Blue Shield plans of Texas and Illinois are both owned by Health Care Service, a giant nonprofit.

Most Obamacare enrollees’ monthly insurance bills will go up substantially next year because of reductions in federal subsidies that help pay for their coverage. Enhanced payments passed by Congress in 2021 will lapse at the end of December. The drop-off in subsidies is both helping to drive higher premiums and making it harder for many consumers to pay them.

Some people “are going to be hit with this double whammy” of bigger monthly insurance bills and losing the subsidy that blunts their cost, said Cynthia Cox, a vice president at KFF.

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The U.S. Health Care Freedom Plan, an integral component of The Leviticus 25 Plan, restores citizen-centered healthcare by eliminating governmental bureaucratic bloat, skyrocketing premiums, unfriendly and complicated medical access pathways, cumbersome, drawn-out claims processing, and rapidly shrinking reimbursements for physicians, pharmacists, and other health practitioners.

The U.S. Health Care Freedom Plan offers a powerful new access strategy for patients receiving medical and pharmaceutical services, home medical equipment, and home care services.

The Plan grants citizens the freedom to pay directly, in person, for health care plan premiums, and for their week-to-week health care purchases. It cuts out layers of bureaucracy and middlemen … simplifies access to health care and restores genuine ‘patient-provider’ relationships.

The U.S. Health Care Freedom Plan is the only comprehensive, citizen-centered health care plan in America.  It ‘resets’ the health care industry to present a clean, efficient and responsible system.  Most importantly, this plan restores individual citizen-centered health care for all participating Americans.

The U.S. Health Care Freedom Plan is available to each and every U.S. citizen – with no coverage mandates. Each U.S. citizen who wishes to participate will be granted a full and complete exemption from the ACA.

Each participating U.S. citizen shall receive a direct credit extension, through a special Federal Reserve / U.S. Treasury Citizens Credit Facility of $30,000, electronically deposited into a Medical Savings Account (MSA) – for direct allocation toward family health care needs.

Private insurance – Families shall be allowed to enroll in high-deductible major medical plans, that include basic, ‘no frills’ medical plans which best suit their individual needs and desires. These streamlined plans would lower premium costs for employees and employers, encouraging employers to cost-share savings with employees through incentive-based employer MSA contributions.

Those with extraordinary medical issues may be included in a high-risk category, with such plans being eligible for a government subsidy (similar to current Medicare Advantage).

Federal / state programs – Individuals enrolled in Medicare / Medicaid / VA / TRICARE / FEHB programs would maintain their covered status, with an annual deductible of $6,000 per year per enrolled family member, for a period of five years for those benefits. The dedicated MSA funds would fully fund the offset for the higher ($6,000) deductible feature for that five-year period. MSA funds could also be used to pay Medicare supplement premiums and other potential co-pay obligations.

Where health care services paid by patients directly with MSA funds, providers would not be bound by federal / state rules pertaining to Electronic Medical Records (EMRs), and other unnecessary administrative burdens.

………………………………….

The Leviticus 25 Plan activation period is slated for the 5-year period beginning in 2026 and ending in 2030.

The Leviticus 25 Plan – Each participating U.S. citizen will receive a $60,000 deposit into a Family Account (FA) and a $35,000 deposit into a Medical Savings Account (MSA).

Qualification: All U.S. citizens residing in the United States are eligible to participate, contingent upon meeting qualification standards and agreement to specified recapture provisions. Participants (other than ‘custody account’ applicants) must prove stable credit history, stable job history, no recent drug/felony convictions.

These general recapture provisions include:

• Waiving all federal income tax refunds for a period of 5 years.
• Waiving benefits from income security programs, select benefits from means-tested welfare programs, SSI, and SSDI for a period of 5 years.
• Enrollees in the Medicare, Medicaid, VA Healthcare system, Federal Employees Health Benefits (FEHB), and TRICARE will be subject to a $7,000 deductible for primary care and outpatient services annually for a period of 5 years. (See full plan for more details)

The Leviticus 25 Plan generates $37.303 billion federal budget surpluses annually during each of its first five years of activation (2027-2031), and pays for itself entirely over a 10-15 year period.

The Leviticus 25 Plan – An Economic Acceleration Plan for America

$95,000 per U.S. citizen – Leviticus 25 Plan 2026 (33715 downloads )

A Wall Street Journal editorial several years ago by Justin Haskins and Michael Hamilton of the Heartland Institute was a step in the right direction.  At the same time, it was weighed down by several major flaws…

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Give Medicaid Dollars Directly to Patients – WSJ

Apr 12, 2017: As Republicans take another crack at devising a plan to replace ObamaCare, here’s an idea they should consider: Give each Medicaid patient a health savings account—and put $7,000 in it every year.

Under ObamaCare, Medicaid has become the only option for millions of Americans. But that doesn’t mean much if the doctors in their communities don’t accept new patients through the program—and 30% of physicians don’t.

Full article accessed via Lux Llibertas:

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“Give Medicaid Dollars Directly to Patients” – shortcomings:

This plan does nothing to offer exemptions from ObamaCare.

This plan does nothing to benefit working families NOT on Medicaid.

It does nothing to untangle and change the complexion of other government health care programs like Medicare, Medicaid/CHIP, VA, FEHB, TRICARE.

This plan is an ongoing, open-ended cash-based subsidy.

There is a better way.

The U.S. Health Care Freedom Plan, an essential component of The Leviticus 25 Plan, is the only comprehensive, citizen-centered health care plan in America.  It ‘resets’ the health care industry to present a clean, efficient and responsible system.  Most importantly, this plan restores individual freedom and liberty for all participating Americans.

The Plan:

1. The U.S. Health Care Freedom Plan is available to each and every U.S. citizen who wishes to participate – with no coverage mandates. Each U.S. citizen who wishes to participate will be granted a full and complete exemption from the ACA.
2. This plan offers freedom of choice and equal justice for all. Those Americans who might wish to stay with the ACA may stay (‘If you like your ObamaCare, you can keep your ObamaCare’).
3. Each participating U.S. citizen shall receive a credit extension, through a special Federal Reserve Citizens Credit Facility, of $35,000, electronically deposited into a Medical Savings Account (MSA) – for direct allocation toward family health care needs.
4. Each participating U.S. citizen will then have a $7,000 deductible for each of the five years of activation (2027-2031) for primary health care claims related to Medicare, Medicaid, VA, TRICARE, FEHB.
5. Private insurance – Families shall be allowed to enroll in high-deductible major medical plans. These streamlined plans would lower premium costs for employees and employers, encouraging employers to cost-share savings with employees through incentive-based employer MSA contributions.
6. Policies would not be automatically loaded with expensive government healthcare mandates.
7. Those with extraordinary medical issues may be included in a high-risk category, with such plans being eligible for a government subsidy (similar to current Medicare Advantage).
8. Federal / state programs – Individuals enrolled in Medicare / Medicaid / VA / TRICARE / FEHB programs would maintain their covered status, with an annual deductible of $6,000 per year per enrolled family member, for a period of five years for those benefits. The dedicated MSA funds would fully fund the offset for the higher ($6,000) deductible feature for that five-year period. MSA funds could also be used to pay Medicare supplement premiums and other potential co-pay obligations.
9. Where health care services paid by patients directly with MSA funds, providers would not be bound by federal / state rules pertaining to Electronic Medical Records (EMRs), and other unnecessary administrative burdens.

Benefits:                                                                                 

Lower health care costs – With the elimination of millions of minor insurance claims across the nation over the course of each month, system-wide efficiency would improve, medical costs would drop significantly, and the direct patient-provider relationship would be restored. Medical professionals would not have to answer to HMOs, insurance companies, or government agencies in providing basic day-to-day healthcare access for their patients.

Scoring – if 240 million U.S. citizens were to participate in the plan, the total dollar transfer into family-based Medical Savings Accounts (MSAs) would amount to $8.4 trillion.

The potential cost savings from the $7,000 deductible provision for the approximate 173.5 million people currently enrolled in Medicare (69.6 million), Medicaid / CHIP (77.0 million), VA (9.2 million), TRICARE (9.4 million), and FEHB (8.3 million) would amount to just under $5.25 trillion over the first 5 years (or, 62.5% of the $8.4 trillion initial roll out cost).

Summary:

This plan would generate trillions of dollars in cost savings from streamlining, vastly improved efficiency, and reductions in waste and fraud.

This plan would improve quality and ease of access to health care for all participating Americans.

 For patients: It would dramatically lower the cost of health care, while improving quality and access for all who chose to participate.

 For providers:  It would streamline payment dynamics and improve reimbursement for services, and restore the patient-provider relationship, and significantly reduce massive cost and time burdens imposed by a centralized system.

 The U.S. Health Care Freedom Plan is an integral feature of a larger, comprehensive economic plan: The Leviticus 25 Plan.

The Leviticus 25 Plan 2027 – An Economic Acceleration Plan for America

$95,000 per U.S. citizen – Leviticus 25 Plan 2026 (32591 downloads )