Obamacare 3.0: A preview

Open enrollment for Obamacare insurance plans began on Sunday as the program enters its third year of troubled operation.

To date, 10 out of 23 of the non-profit insurance exchanges have gone under due to rising costs and fewer enrollees.  What makes the demise of this market so significant is that the mix of healthy and sick customers appears to be about the same for both the nonprofit and for-profit insurance carriers.  It is believed that the rising costs of Obamacare insurance premiums may be unsustainable, given the failure of the "risk corridor" program to adquately reimburse insurance companies for their losses.  Some companies have even pulled out of some states, while others have added coverages in other states. 

So premiums are up many by double digits and employers are beginning to pass on increased cost to their employees by purchasing plans that feature higher deductibles and more out-of-pocket spending.

Reaction to Obamacare in Texas may be atypical, but is instructive as to why Obamacare is a slow-motion failure:

“It doesn’t get a very high grade in my district,” said local Rep. Randy Neugebauer, who is known nationally for yelling “baby killer” as Congress debated the Affordable Care Act five years ago. Neugebauer, who represents 29 predominately rural counties from the New Mexico border to central Texas, added: “I think a lot of people are finding that it’s just not affordable.”

With some of those difficulties in mind, the administration announced modest goals for national signup growth — a target of 10 million people covered through the health law’s exchanges by the end of 2016, or a net increase of roughly 1 million. Its most intense outreach efforts will focus on five metropolitan areas with high concentrations of the uninsured, including Dallas and Houston.

But Dallas and Houston seem worlds away from Borden County, parts of which are so remote they don’t have running water or Internet access. It had one of the lowest Obamacare enrollments in the country this past year, along with Yakutat City and Borough in Alaska, according to administration data. Part of that low enrollment may be because many Borden County residents get health benefits through jobs in the local school system, on oil rigs and on cattle and cotton ranches, so only about one in six was uninsured in 2013. Part of it may be because of its conservative leanings and remoteness.

Outreach workers who are supposed to educate people here and in other parts of west Texas must travel huge distances to find small pockets of the uninsured — people like Copeland and her daughters, Becky Justice and Rika Law, both married women with children. And all of them think the Affordable Care Act is anything but affordable.

Copeland said her income fluctuates but she made about $19,000 last year; she didn’t know that she would have qualified for significant subsidies to lower her monthly insurance premiums, as well as for lowered co-pays and out-of-pocket costs. A plan for the coming year in the mid-priced, most popular tier would cost about $200 a month, after subsidies are figured in.

When she did learn about the subsidies, she softened her stance slightly and said she might look into it. But she said she’s done just fine without health insurance most of her life and is still angry that the federal government can mandate she has to buy it.

“At this point, I don’t mind them penalizing me,” she said.

Everyone may not be aware of subsidies, but almost all Americans know about the individual mandate.  That stubborn streak of independence the same stubborness that led to a group of ragtag colonists telling England to go to hell is why Obamacare is becoming more expensive and less popular despite the millions who have signed up.  There just aren't enough healthy people of any income level who will accept the inferior coverage and high deductibles offered by Obamacare.

There are several ideas circulating in Washington on what to do about Obamacare, from full repeal to a "repeal and replace" plan to a complete takeover by government of the entire health care system.  The American people don't care much about the politics of the issue; they just want affordable health insurance without the government telling them what, if anything, they have to buy.

Obamacare is not providing that and is making the situation worse for millions.