Any attempt to fix the health insurance situation was bound to draw the “people will die in the streets” accusations from the left. It would not make any difference what the Repubs tried to pass, the outcry would have been the same.
Never mind that Obamacare still leaves 30 million with no coverage at all, at its very best. Where was the outcry for them?
Obamacare was doomed to failure. Everybody knew that. Even when it was passed, everybody knew it. It was to be the prelude to total government healthcare, which the Dems in the House wanted but not enough in the Senate did. So they cobbled Obamacare together so they could claim to have saved the day until next time.
It has a lot of parts. At the core, its main parts are:
- Pushing 17 million onto Medicaid that were not on it before. Some had employment-based insurance and some didn’t. Nobody knows who they really were or what would have been best for them. It was just “you fit this category, so off to Medicaid you go”. Providers limit the number of Medicaid patients they’ll take, so the TRULY poor who had no other resource find fewer provider slots for them.
- Creating an actuarially inappropriate “pool” with the exchanges. People who did not have employment-based insurance (increased because employers utilized the “30 hour rule” to push people off their programs) and the virtually uninsurable were pushed into what was, in reality, a distorted high risk pool, in which those who could have bought their own insurance could no longer do so. It was an “income redistribution” scheme in which an unfortunate part of the middle class pays for another part of the middle class, because some received generous subsidies and some did not. Insurers couldn’t figure out what the losses would be, which is why so many pulled out.
- Imposing mandates a lot of people didn’t need or want; the most egregious being the requirement that employers pay 100% of the premium for contraceptives and abortifacients (including Catholic nuns). People had no choices at all in their coverages. You bought them all or none. So, 55 year old women pay for prenatal care for themselves, among other things.
- Destroying the “child only” policy market. It was probably the least expensive coverage of all before Obamacare. One more “help” for the poor.
- Creating taxes that applied to a) those who couldn’t afford to pay the ever-increasing premiums, and b) people whose adjusted gross income exceeds $250,000. It didn’t apply to 401Ks or IRA’s. AGI is a lot less than Gross Income, so that tax applied to very few, and was totally inadequate to pay for the subsidies. People like to call this a “tax on the rich”, whereas it’s far more a “tax on the middle-middle class”.
Obamacare is “Rube Goldberg” all the way. The idealization of it, and the refusal to see its defects (and non-coverage of 30 million) is a purely political thing. One can argue that it should be replaced this way or that way, but it’s beyond argument that it needs to be replaced. Democrats want total government healthcare. Repubs want a free market. Nothing is going to be perfect because despite all the romanticism, healthcare itself is and will remain a scarce resource. That’s particularly true in the U.S. where we have had open immigration of unskilled people for decades and serious and unaddressed concentrations of social problems.