At the American Action Forum, I have been fortunate enough to learn from some of the smartest people in Washington, including former CBO director, Doug Holtz-Eakin. In a meeting with all of the AAF interns, Dr. Holtz-Eakin told us, “It’s about making good policy good politics.” This has resonated with me throughout the past couple months, especially as we near the Presidential Election. As I look at the President’s most notable piece of legislation, the Affordable Care Act (ACA), I notice that Obama has tried to make good politics good policy. He has added more individuals into failing safety net programs, increasing pressures on our struggling healthcare system and economy.
In health policy analysis, we focus on three main aspects of healthcare: access, cost, and quality. The ACA has increased access to healthcare, but does not adequately address cost or quality. One of the goals of the ACA was to guarantee that more Americans have health insurance. The main tool to ensure that all Americans are covered was the individual mandate. Theoretically, the individual mandate would have given Americans direct coverage and health insurance, translating into greater access to health care.
Another piece of the legislation is the employer mandate. The employer mandate is similar to the individual mandate, but employers are responsible for providing insurance for their employees (unless the company has fewer than 50 employees). Again, the idea is that increased coverage would lead to a greater access to healthcare.
This legislation does little to drive down costs in our healthcare system. Increasing coverage under Medicare and Medicaid has ultimately exasperated our current healthcare financial crisis. In fact, the ACA pays for this legislation by using preexisting Medicare funds; thus, draining the already depleted Medicare pool.
Improving access means that in some regions, where healthcare costs and quality are already problems, more people will burden failing healthcare systems. In areas with good healthcare systems, this means these systems will still be saddled with more patients. It will be difficult to maintain sustained healthcare standards when more patients will be admitted while hospital resources remain the same. Ultimately, this move will hurt quality. More people will burden the healthcare system with no plan to help decrease costs and effectively increase quality. The law has aggravated the worst aspects of the U.S. health care system, without ﬁxing what is broken.
Many would argue that President Obama’s health care law is his biggest accomplishment as President. Recent data has shown that the law has in fact increased access to care. Unfortunately this was the right political move, not the right policy move. When it comes to healthcare, Americans feel as if everyone should have equal access since healthcare directly influences the livelihoods of families in America. This sentimental notion makes this a very strong political selling point for Democrats. Moreover, the notion of equality for all is very strong in America. President Obama took the easy route.