ObamaCare’s Spending Problem

It comes as no surprise that spending under ObamaCare has quickly accelerated out of control, with sky high premiums resulting from the lengthy list of procedures insurance companies are now required to cover. Further forcing costs up are system expansions, such as California has seen. Medi-Cal, insurance for low-income California residents, now covers a third of the state.

ObamaCare was billed as a way to make health insurance affordable, but it fails to acknowledge how this coverage expansion drains the wealthy and harms insurance companies, forcing them out of the insurance marketplace or to raise their premiums.

Since those with a pre-existing disability already qualified for programs like Medi-Cal and most gainfully employed individuals had coverage through work or could afford independent coverage, those who benefit most from the new programs are those seeking non-necessary care that companies are forced to cover.

Insurers Say No More

Insurance is a business just like any other. In order to stay afloat, these companies need to cover a fair number of low-risk patients who pay into the system while drawing little for most of their lives -- checkups, the occasionally course of antibiotics, a single broken bone.

Of course, there’s a lot of uncertainty in this process. Insurance companies can’t predict when a formerly low-risk patient will become ill. But if those individuals have paid years of premiums, costs may even out. Additionally, since ObamaCare no longer allows insurance companies to exclude those with preexisting conditions, newly insured individuals can buy into the system and immediately require hefty payments.

Take Brittany Long’s case as an example. Long is an Ohio resident who makes too much for Medicaid and is self-employed, therefore she didn’t have insurance through her job when she became serious ill.

Long has a brain condition known as a Chiari malformation and is in over $60,000 of medical debt -- and hasn’t been able to access key procedures yet. She’ll likely marry her boyfriend and enroll in his insurance -- forcing them to pay out and contributing to the epidemic of rising premiums. And because of ObamaCare, the company can’t stay no, hurting their bottom line.

Dr. Lee Hieb, an orthopedic surgeon, compares selling health insurance to a patient like Long to selling fire insurance to someone whose house is already on fire. It’s a terrible business move and is a recipe for financial ruin -- and ObamaCare demands it. These patients are why insurers are leaving the insurance marketplace and selling only to independent buyers.

The Unnecessary Care Pile Up

In addition to taking on higher risk patients, ObamaCare is running up costs and running insurance companies out of the marketplace by requiring these insurers to offer a long list of unnecessary procedures and treatments. In some cases this is a simple conflict of biology -- why does a single, older man need to have insurance that covers maternity care of so-called emergency contraception?

The long list of required coverage also requires insurance companies to take responsibility for care related to the reckless behavior of those covered. STI screenings, obesity counseling, or interventions surrounding tobacco use are all issues that fall within the category of poor choices, not subjects of necessary medical care. These are just some of the poor life choices that tax payers are being asked to finance.

When looked at closely, it would make more sense only to cover care that reduces future problems. Consider tonsillectomies -- children often have their tonsils removed to reduce future cases of strep throat in cases where infection is frequent or somewhat resistant to treatment. Tonsil and adenoid removal surgeries can also improve breathing in adults, reducing snoring and resolving sleep problems. This is the type of procedure that fits well into a shared risk model.

Staying The Old Course

ObamaCare is an unnecessary and unsuccessful attempt at reforming a system that was working just fine, primarily by increasing coverage levels. Unfortunately, this increase works against the ideal, low-cost approach to insurance: have as little as you possibly can. The poor and the elderly had access to Medicare but are a limited population and everyone else could take advantage of health care savings accounts or acquire coverage through their place of employment.

As for those with pre-existing conditions -- the ones draining our system? They should be pooled as a high-risk group, separate from the rest of insurance buyers. This can rebalance the system by lowering demands on companies and empowering healthy, responsible Americans to make independent choices about their level of coverage.

ObamaCare is draining funds from responsible, steadily employed taxpayers to pay for the self-inflicted choices of free riders. It’s time to acknowledge that this system isn’t working -- rather, it’s destroying insurance companies and encouraging spending on an array of unnecessary procedures.

This is enabling bad policy, the outcome of a nanny state gone out of control.

It comes as no surprise that spending under ObamaCare has quickly accelerated out of control, with sky high premiums resulting from the lengthy list of procedures insurance companies are now required to cover. Further forcing costs up are system expansions, such as California has seen. Medi-Cal, insurance for low-income California residents, now covers a third of the state.

ObamaCare was billed as a way to make health insurance affordable, but it fails to acknowledge how this coverage expansion drains the wealthy and harms insurance companies, forcing them out of the insurance marketplace or to raise their premiums.

Since those with a pre-existing disability already qualified for programs like Medi-Cal and most gainfully employed individuals had coverage through work or could afford independent coverage, those who benefit most from the new programs are those seeking non-necessary care that companies are forced to cover.

Insurers Say No More

Insurance is a business just like any other. In order to stay afloat, these companies need to cover a fair number of low-risk patients who pay into the system while drawing little for most of their lives -- checkups, the occasionally course of antibiotics, a single broken bone.

Of course, there’s a lot of uncertainty in this process. Insurance companies can’t predict when a formerly low-risk patient will become ill. But if those individuals have paid years of premiums, costs may even out. Additionally, since ObamaCare no longer allows insurance companies to exclude those with preexisting conditions, newly insured individuals can buy into the system and immediately require hefty payments.

Take Brittany Long’s case as an example. Long is an Ohio resident who makes too much for Medicaid and is self-employed, therefore she didn’t have insurance through her job when she became serious ill.

Long has a brain condition known as a Chiari malformation and is in over $60,000 of medical debt -- and hasn’t been able to access key procedures yet. She’ll likely marry her boyfriend and enroll in his insurance -- forcing them to pay out and contributing to the epidemic of rising premiums. And because of ObamaCare, the company can’t stay no, hurting their bottom line.

Dr. Lee Hieb, an orthopedic surgeon, compares selling health insurance to a patient like Long to selling fire insurance to someone whose house is already on fire. It’s a terrible business move and is a recipe for financial ruin -- and ObamaCare demands it. These patients are why insurers are leaving the insurance marketplace and selling only to independent buyers.

The Unnecessary Care Pile Up

In addition to taking on higher risk patients, ObamaCare is running up costs and running insurance companies out of the marketplace by requiring these insurers to offer a long list of unnecessary procedures and treatments. In some cases this is a simple conflict of biology -- why does a single, older man need to have insurance that covers maternity care of so-called emergency contraception?

The long list of required coverage also requires insurance companies to take responsibility for care related to the reckless behavior of those covered. STI screenings, obesity counseling, or interventions surrounding tobacco use are all issues that fall within the category of poor choices, not subjects of necessary medical care. These are just some of the poor life choices that tax payers are being asked to finance.

When looked at closely, it would make more sense only to cover care that reduces future problems. Consider tonsillectomies -- children often have their tonsils removed to reduce future cases of strep throat in cases where infection is frequent or somewhat resistant to treatment. Tonsil and adenoid removal surgeries can also improve breathing in adults, reducing snoring and resolving sleep problems. This is the type of procedure that fits well into a shared risk model.

Staying The Old Course

ObamaCare is an unnecessary and unsuccessful attempt at reforming a system that was working just fine, primarily by increasing coverage levels. Unfortunately, this increase works against the ideal, low-cost approach to insurance: have as little as you possibly can. The poor and the elderly had access to Medicare but are a limited population and everyone else could take advantage of health care savings accounts or acquire coverage through their place of employment.

As for those with pre-existing conditions -- the ones draining our system? They should be pooled as a high-risk group, separate from the rest of insurance buyers. This can rebalance the system by lowering demands on companies and empowering healthy, responsible Americans to make independent choices about their level of coverage.

ObamaCare is draining funds from responsible, steadily employed taxpayers to pay for the self-inflicted choices of free riders. It’s time to acknowledge that this system isn’t working -- rather, it’s destroying insurance companies and encouraging spending on an array of unnecessary procedures.

This is enabling bad policy, the outcome of a nanny state gone out of control.