Leftists continue their anti-consumer, anti-free market diatribes in favor of the destructive government debacle known as ObamaCare. A key component of their rhetoric is to castigate the state’s decision not to expand Medicaid under ObamaCare. In today’s column, JLF’s John Hood explains what the Leftists are really after — and it is alarming.
While the current Obamacare debate has focused on the fate of the insurance exchanges, the bill was always primarily about expanding Medicaid. Most of the people forecast to obtain coverage under Obamacare were to do so as new Medicaid recipients, not enrollees of private plans.
Moreover, the flaws in the insurance exchanges reflect not an accident but instead a heartfelt belief by the law’s framers that true health insurance — a financial product to protect households against unforeseen major medical expenses — needs to go away. They were willing to use fedeower to attempt to turn private insurers into regulated utilities. But most of them assumed the effort would fail in the long run, leaving no alternative but to expand Medicare and Medicaid into a de facto single-payer system.
In that one prediction, at least, the framers of Obamacare are likely to be correct. If current trends continue, a combination of adverse selection and moral hazard will render the private exchange plans unsustainable without massive and unpopular government bailouts. If taxpayers are going to be forced to plow more money into the financing system of health care, the argument will go, why not just cut out the middleman and fund the expansion of Medicare (by lowering the eligibility age) and Medicaid (by raising the income-eligibility cap)?
If not ObamaCare and a massive expansion of Medicare and Medicaid, then what?
Many conservatives have an entirely different goal in mind in the long run. We’d like to promote access to medical care for the needy without imperiling private markets or the freedom of Americans to contract with whomever they wish on whatever terms they wish. We envision a system in which all individuals receive refundable, risk-adjusted tax credits with which to purchase health plans or make deposits into health savings accounts. We further envision multiple, voluntary insurance exchanges that compete for the patronage of workers, families, employers, and retirees. Medicare and part of Medicaid would remain a system of what amounts to required savings for retiree health needs, supplemented by general revenues for the poor and severely disabled.
We must chance course — NOW — before millions more Americans lose their existing insurance and are tossed into the failed policy and nightmarish bureaucracy that is ObamaCare.
