The House of Representatives is expected to vote on repealing Obamacare this week. Heritage has already laid out five of the biggest reasons for Congress to repeal the entire law but because the law and its effects are so far-reaching, here are five more:
- Obamacare’s tax credits are overly complicated. The premium tax credits used to offset the cost of coverage in the law’s exchanges vary not only according to income, but also according to family size and the cost of the second-lowest cost silver plan in a recipient’s geographic area. Thus, anytime there is a change in one or more of those three variables, the recipient’s tax credit has to be recalculated. This design is far more complicated than any other health care tax credit proposal offered in Congress before, or since, Obamacare. Furthermore, relative to alternative approaches, the added complexity of the Obamacare tax credit makes it much more likely to be inaccurately calculated, and to cause taxpayers to owe substantial repayments to the Internal Revenue Service when they file their annual tax returns.
- Limited insurer competition and consumer choice. Another one of the president’s many broken promises is that Obamacare would increase insurer competition and choice in the individual market. Heritage research shows that at the state level, the Obamacare exchanges are 21 percent less competitive in 2015 than the pre-Obamacare individual market was in 2013. Worse, competition at the county-level shows that in 2015, consumers on the Obamacare exchanges in one-third of all U.S. counties have only one or two insurers offering them coverage.
- Expansion of the broken Medicaid program. The Medicaid program has a long and well documented history of limited access to care and poorer health outcomes for beneficiaries compared to patients with private insurance. Instead of implementing reforms that would remedy these problems for beneficiaries, Obamacare expands eligibility for the program to anyone earning below 138 percent of the federal poverty level, mainly adding millions of childless adults to the Medicaid rolls in the states that accept the expansion. In fact, enrollment data shows that 89 percent of the law’s coverage gains for the first three quarters of 2014 are due to increased Medicaid coverage—not private insurance.
- Millions remain uninsured. Despite the imposition of an individual mandate to purchase coverage, an employer mandate to provide coverage and adding $2 trillion in new health care spending (Medicaid expansion and exchange subsidies costs from 2016-2025), about 30 million people will still be uninsured over the next decade.
- Payment cuts in Medicare harm seniors. Despite the fact that the Medicare program needs structural reform, Obamacare reduces Medicare spending by an estimated $716 billion from 2013-2022 and uses that money to pay for spending on Obamacare’s new entitlements for the non-Medicare population. Of course, the financing of Medicare directly impacts the quality and quantity of care and services seniors receive. For instance, Medicare Advantage plans have had to reduce benefits and restrict their provider networks as a response to Obamacare’s cuts.
For these reasons and many more, Congress should repeal all of Obamacare to allow for a fresh start to health care reform.