Obamacare

Joe Biden's New Health Care Plan Is an Admission that Obamacare Doesn't Work

Biden is framing his new plan as a defense of Obamacare. It's not.

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Joe Biden is pretending to defend Obamacare while implicitly admitting it has failed to live up to its promises. 

Yesterday, the former vice president debuted a new health care plan, which would expand subsidies in the program while creating a new government-run health insurance plan—a "public option"—that would be available inside the exchanges. 

Currently, people who make up to 400 percent of the poverty line, about $48,000 for an individual or about $100,000 for a family of four, are eligible to receive subsidies for coverage purchased through the law's health insurance exchanges, insulating those people from much of the cost of coverage. Those who make more than the 400 percent threshold, however, tend to face extremely high premiums; Biden's plan would simply cap premiums at 8.5 percent of household income. The additional subsidies, as well as the implementation of the public option, would cost about $750 billion over a decade, according to his campaign—not too much less than the $940 billion Obamacare was estimated to cost over its first decade. 

Biden's plan is notable mostly for its explicit rejection of Medicare for All, the single-payer plan proposed by Sen. Bernie Sanders (I–Vt.) and backed by rival candidates such as Sens. Elizabeth Warren (D–Mass.), Kamala Harris (D–Ca.), and Cory Booker (D–N.J.). The Sanders plan would eliminate virtually all private insurance in the space of just four years, forcing everyone into a single government-run insurance system. By any measure, it would be tremendously disruptive, and polls show that even if the idea of Medicare for All is popular, the elimination of private insurance is not.

It is also a defense of Medicare as it exists today, one that mirrors the tack that President Trump and other Republicans have taken against Sanders' single-payer proposal: At an AARP event last night, Biden warned that with Medicare for All, "Medicare as you know it goes away."

Biden is apparently betting that by campaigning against Medicare for All, and the socialist tendencies it represents within the Democratic party, he can win over moderate voters. Biden is also framing his approach as a way of preserving and building on top of Obamacare, which as vice president under President Obama, he helped usher into law. 

In a video touting his plan, Biden said he was proud of his work on the health care law, calling it a success, and warning that passing Medicare for All would meaning getting "rid of Obamacare." The public option, he says, is the best way to "lower costs and cover everyone." 

Given Biden's role in the passage of Obamacare, it would be difficult for him to simply run against it because to do so would be to admit that the most prominent initiative of the Obama administration—sorry, the "Obama-Biden administration"—was a failure. Biden's rivals who are running on Medicare for All, which would blow away the current system, are explicitly running on this notion. 

Yet Biden's new plan essentially makes this admission anyway. Obamacare was supposed to provide coverage to those who don't have it and lower the price of health care, but for all intents and purposes, that is the same promise that Biden is now making about his plan.

Indeed, when Biden talks about building on the existing system, he sounds more than a little like Obama did when selling Obamacare: "I believe it makes more sense to build on what works and fix what doesn't, rather than try to build an entirely new system from scratch," the former president said in a 2009 speech making the case for the law. Biden is pitching an expensive overhaul of Obamacare on the promise that it would do what Obamacare was supposed to have already done. Which means that for all the feisty back-and-forth about health care policy, nearly all of the Democrats running for president appear to agree on at least one thing: Obamacare isn't working. 

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  1. They never intended that Obamacare work. They wanted it to raise expectations about what a person is entitled to while damaging the existing system to the extent that it would be impossible to go back, and to make further socialization more attractive. It was never the end state they wanted.

    1. I think you give them a bit too much credit. You have to remember that Obamacare as originally intended contained the public option. The plan was to make private healthcare expensive and worthless and the public option more attractive such that companies would stop offering healthcare insurance and everyone would end up on the public option and single payer would happen by default.

      This is why so many corporations supported Obamacare. They saw it for what it was and as a way to get out from under providing health insurance to their employees.

      The first problem was that they couldn’t get Obamacare passed without dropping the public option. The solution to that was to put off the implementation of Obamacare until 2014. The Democrats figured that would give them time to win all of these elections because of their great triumph and then go back and fix Obamacare once they had a larger majority and create the public option.

      Well, the second problem was that didn’t happen. They got killed in the 2010 midterms making passing the public option impossible. So, they were stuck with a plan that was designed to do tremendous damage to the private health insurance market but without a public option to replace it. But, since the whole thing was a lie and they claimed you could keep your insurance, they couldn’t admit that. So, they just sat there and watched it do all of this damage.

      1. Obamacare needed money from the uninsured via the compliance tax. But that never really got the push it needed. Keeping people’s tax returns because they did not have health insurance would never really be a popular idea once implemented.

        I always found it ironic when I ran into someone who complained about not having health insurance and supported Obamacare. They were not following the law they supported.

        1. The entire thing was insane. They actually thought that forcing people to buy health insurance was going to lower healthcare costs because they would get “preventive care” that would save money over the long term. Think about how stupid that is. First, if preventive care really saved money, insurance companies would not only be covering it, they would be forcing people to take it as a condition of the policy.

          Second, when you force people to pay for something, they are going to use it where they would not have before. So, to the extent it did give coverage to people who didn’t have it before, it just raised costs as those people consumed services they were not consuming before then.

          I think people believe it was a plot to create single payer because they can’t believe anyone could be dumb enough to believe what the proponents of Obamacare claimed to believe. I disagree. I think they really were that stupid.

          1. On top of all that, the law also conflates the healthcare market with the health insurance market. The two are intertwined, obviously, but they figured that by getting all of these young healthy people into the market, they’d bring overall costs down (lets transfer wealth from the struggling college grad to the comparatively wealthier baby boomer that made poor financial choices).

            Instead, we got a bunch of people that have health issues into the market, which applied upward pressure to the demand curve and caused health insurance premiums to increase along with cost-savings mechanisms like deductibles. Getting sicker people into the market could be seen as a feature if we could actually push health care costs down, but they didn’t do anything to get healthcare costs down except for dumbass magical thinking like what John highlighted. At this point, costs will only come down if we deregulate and allow doctors to compete based on price.

            Health insurance for anything other than catastrophic issues has me perplexed anyway. Why are we insuring things that will most certainly happen? You WILL need health care during your lifetime. Usually, we insure things on the off chance that they might happen, but when they do, the cost will certainly be very high. Instead, we’ve insured everything right down to having your temperature taken at the doctors office. This has separated the buyer from the seller, and, when combined with the regulatory clusterfuck our government has set up, has obliterated any and all price competition.

            1. Why are we insuring things that will most certainly happen?

              Because we don’t know how much the costs will be, so there is no way to plan for them. My medical costs for the rest of my life could be anything from virtually zero, if I die of a heart attack sitting at my desk, to millions of dollars, if I get some long term disease. There is no way to say with certainty which it will be or how close to one or the other extreme. So, I can’t save money and plan for it.

              I buy insurance because the insurance company can insure me in a group of people of similar risk and since they are paying the aggregate, can give me a price that I can plan around.

              1. My medical costs for the rest of my life could be anything from virtually zero, if I die of a heart attack sitting at my desk, to millions of dollars, if I get some long term disease

                I think you’re missing my point. You’re supposed to insure for those horrible expensive things that MIGHT happen to you. Instead, we insure for everything. Have a flu shot ever year? Insured. Want to get your weight during your checkup at a doctors office? Insured.

                Its stupid.

            2. “Why are we insuring things that will most certainly happen?”

              Because it’s a natural out growth of unions + employer paid health insurance.

              So why do we have employer paid health insurance in the first place?

              Because of government interference in the domestic labor market during WWII.

              To save money on equipment/materials/goods for the war, the US federal government enacted wage caps.

              However the labor market was tight, due to all the young men over in Europe fighting the war. Since employers couldn’t compete for scarce labor on direct compensation (wages), they invented the concept of indirect compensation (all those things that fall under the rubric of employment “benefits”). Life insurance, health insurance, pensions. Unions loved the indirect compensation idea so it was impossible to get rid of after the wage caps went away.

              1. None of that has anything to do with the need to buy health insurance. I can’t for the life of my understand why so many people cannot grasp how insurance works.

                You can insure anything; provided the cost is uncertain but the risk can be quantified. That is it. Health care is the perfect example of costs that are conducive to insurance.

                1. It would be insurance if premium depended on relevant risk. ACA forbids that. It’s just redistribution, but mostly people are ok with that dressed up by the current system.

                  1. You always pool your risk with someone. Otherwise it wouldn’t work. But, one of the worst things Obamacare did was require insurance companies to pool risk by community rather than by similar risk groups. The idea was to fuck healthy people out of as much money as possible.

                    1. When those healthy people also support forcing insurance companies to cover new insureds with pre-existing conditions, which is insane and completely contrary to the fundamental principles of insurance, I have little sympathy.

                2. Maybe I wasn’t clear in my original post, but I was pointing out that we SHOULD insure things that have uncertain cost and may occur. Things like cancer procedures, brain surgery, liver transplants, etc. The list goes on and on. That stuff makes sense to insure.

                  My issue is that we insure everything having to do with healthcare, a lot of which is predictable, should have easily discoverable costs and occur on a regular basis with virtually every patient in the same age/sex bracket.

              2. The problem with Obamacare was that, although the marble rolled down the slide, and hit the dominoes, and the head of the drinking bird dipped into the glass, the liquid in the drinking bird’s body did not move up the tube to the head of the drinking bird,and so, the cage didn’t drop on top of the mouse.

              3. Exactly. Matt nailed it. Insurance is a leftover from a misguided government policy during WWII, and we still feel the aftereffects today. Its a shame.

      2. Remember how vital it was, for reason, for the GOP to create an “alternative” to Obamacare.

        Reason didn’t think “Just don’t have Obamacare with no alternative” was good enough. The editors here DEMANDED that the GOP develop some large, overarching government program.

        because Reason is libertarian AF…AMIRITE?

        1. Completely agree with this comment.

        2. That’s Suderman’s stance, at least. Since that’s his beat, I guess it can be said that it is Reason’s position.

    2. I don’t thin they are competent enough to plan ahead even a few seconds, let alone past the current election.

      More likely they just flounder to see what sticks. They don’t care what it is, they have no principles, no actual goals other than getting votes to get power. If they thought government-run astrology would do the trick, they’d be arguing over how many new signs could be squeezed in.

  2. Any problems with Obamacare are the result of Republicans sabotaging it.

    1. and the Kulaks

      1. Don’t forget the hoarders and wreckers! We must be inclusive!

    2. True Obamacare has never been tried

      1. They just needed more Top Men.

    3. …and the gypsies, the Free Masons and of course, the Jews.
      Don’t forget the Jews.
      They’re the reason everything is bad in the world.
      Just ask Representative Omar from Minnesota.

  3. Biden is also framing his approach as a way of preserving and building on top of Obamacare, which as vice president under President Obama, he helped usher into law.

    “This is a big fucking deal,” Biden said at the time. Instead, it turned out to be a big deal fucking-over of Americans. (You can use that pithy quote, free of charge.)

  4. The nationalization of all American health care is what the socialists are proposing. Calling it medicare for all is as made up as ‘if you like your coverage you can keep it. Period.’

    People pay into medicare for their entire working lives. Are these new recipients going to pay $100,000 of their own money (not my taxes) to get in? Didn’t think so.
    And oh, by the way, medicare only covers 80% of medical expenses, with NO ANNUAL LIMIT ON OUT OF POCKET COSTS. Is that part of the socialists plan? Didn’t think so.

    So no more “medicare for all”; call if fascist nationalization of health care” which is what it is.

    1. Nope, the nationalization of insurance is the proposition. You must like watching insurance commercials and paying executives tens of millions.

      1. That is right. The way to fix a problem is to make sure no one in the industry makes any money. What we do without geniuses like you shreek giving us insights like that?

        1. It works with our military.

          1. No it doesn’t. The military is incredibly inefficient. It is only socialist because its job is to kill people and in that environment socialism and one for all is the only way to survive. Moreover, try not paying the military or paying it less than the market value for the people giving it labor and see how well it works.

            Your logic can apply to anything. “You don’t want a government takeover of the auto industry, you must like car commercials and auto execs making millions”. It is hard to overstate how fucking stupid your statement is.

          2. Why are you still running this stupid sock Screech?

          3. “”It works with our military.”‘

            Hahahahahahahaha.

            You have no experience in this area. Obviously.

          4. Yeah, if it’s one institution that never has problems, it’s military medicine.

          5. Trying to nationalize private business should be a criminal offense. In fact, part of a constitutional amendment criminalizing the practice of Marxism.

      2. And that’s a horrible proposition. As difficult as working with insurance companies can be, how easy do you think it’s going to be to argue with the federal government and their fucking “sovereign immunity”?

        By the way, have you looked at Congress and how they handle the budget lately? It’s a disaster! Why is putting healthcare insurance in the middle of that mess a good idea?

        And think about this: if Obama had achieved this, who would be running our healthcare system today? Think hard now.

  5. The democrats campaigning on healthcare is one of the more shameless political strategies I think I’ve ever seen.

  6. http://www.bing.com/videos/search?q=Fast+Times+at+Ridgemont+high+car+crash+scene&view=detail&mid=77A7708E4C3ACFE0206F77A7708E4C3ACFE0206F&FORM=VIRE

    The Camaro is the American Health Care System. Jeff Spicoli is the Democrats. We have now reached the point in the scene were Biden tells us “my dad, he is a television repair man. He has an awesome set of tools. I can fix it.”

    1. It would be like Republicans campaigning on overthrowing what ever the current regime is in charge of Iraq.

      1. Exactly. The shamelessness of it is astounding even for politics.

    2. The Camaro is the American Health Care System. Jeff Spicoli is the Democrats. We have now reached the point in the scene were Biden tells us “my dad, he is a television repair man. He has an awesome set of tools. I can fix it.”

      Alessandro Ambrosio’s got my vote.

      1. Jennifer Jason Lee. She is like 60 now and still isn’t bad. She was just awesome back in the day.

        1. I’m retarded. I was thinking about Phoebe Cates AOC in Phoebe Cates’ role.

          1. With Beto playing Judge Reinhold jerking off in the bathroom.

            1. Hollywood needs to get off this identity politics bullshit and get to work on this.

            2. LOL now that you mention it the resemblance is uncanny. Except, of course, that Judge Reinhold was acting.

    3. people on ludes should.not.drive.

      seen the new Playboy? Bo Derek’s tits! I like sex.

  7. And he said that ‘if you like your current health insurance plan, you could keep it.’ And they say hew slept through his Vice President job – clearly he learned something from Obama.

  8. God these people are scary: “We’re not Venezuela! Now, let’s do price controls!”

    1. “We’re not Venezuela! (left unsaid: yet, but we want to be)”.
      FTFY.

  9. Biden is apparently betting that by campaigning against Medicare for All, and the socialist tendencies it represents within the Democratic party, he can win over moderate voters.

    The problem is that Ol’ Grabby Hands is still a senile idiot, moderate or not.

    1. That and the fact that there are no moderate voters left in the Democratic Party means it doesn’t look good for old Joe.

      1. And how much hay could be made of Biden helping his kids business with foreign policy positions under Obama?

        1. Let’s be honest…those “investments” in Kerry’s and Biden’s kids’ firm wasn’t a payment to the kids. It was a payoff to their dads, set up to avoid financial disclosure laws.

          1. Nobody in their right mind is giving Biden’s cokehead fuck-up son millions of dollars to invest if they’re not getting something in return from his old man.

  10. I notice he selected AARP, the insurance company shill organization, as the place to pretend he gives a damn. Good move.

    1. I am not sure what is funnier; that Biden’s only appeal amounts to “well he doesn’t seem as crazy as the rest of them” or that it might work.

  11. We have the Affordable Care Act (ACA) and we can build on that framework. The Republican despite years of saying “repeal and replace” have come up with nothing. Medicare for All is a pipe dream that dies when it hits the Senate. So building on the ACA is not an admission of failure but and acknowledgement that more needs to be done. And frankly, at this time, updating the ACA is the only real game in town.

    1. This time it will be different. Yeah, sure it is. Jesus Christ, how do you people believe this bullshit? It takes a special sort of stupid to not only completely fuck something up, anyone can do that, but then see the fuck up and think “we just need more of the same”. You people are terrifying.

      1. This time it will be different. Yeah, sure it is.

        I’m pondering the need to put on my shocked face when they figure out that some people could consider tying immigration directly to the safety net as feature rather than a bug. I’m almost certain there’s a plan or action item or memo out there somewhere that points out that they could kill lots of birds with one stone by ‘importing’ younger, healthier immigrants to round out the quotas that the ACA failed to fill.

      2. And what is your healthcare plan, John?

        This discussion is not served by partisan propaganda junkies like yourself.

        1. My healthcare plan is to do this magical thing called increasing the supply of it. It would consist of breaking down professional barriers so varies levels of professionals can do more than they can now, funding the building of new medical and nursing schools, and allowing the immigration of more healthcare professionals.

          One of the most amazing things about Obamacare was during the entire debate no one ever once mentioned increasing the supply of healthcare. That is because it had nothing to do with healthcare. It was just about stealing.

          1. Being in the field I really do not think those things will substantially reduce costs, much less reduce total spending.

            The only things that will reduce both of those is when the consumer is the actual payer. Meaning any spending is really coming out of their hide AND they know what the actual price is.

            1. Consumers don’t act like perfectly rational consumers when they’re buying potato chips, let alone healthcare. If your choice is bankrupt or due, you choose bankrupt. That’s why it’s a special market that in every civilized country is handled by governments.

          2. I disagree about the supply bring down costs. We have significantly more health care today and costs continue to go up. Recent developments of a treatment for hepatitis C allows treatment but at a cost between $50K and $100K per patient. Many health care providers use PA and Midwives as first line providers. Those professional have to be backed by a doctor because that is the professional with the final authority. You know Midwives are a great alternative for childbirth, but if a c-section is needed you go back to an OBGYN. Women today are older when they have there first child. The baby is better cared for in utero and so is bigger. And so we have more C-sections and require OBGYNs. You can not apply supply side economic here.

    2. “So building on the ACA is not an admission of failure but and acknowledgement that more needs to be done.”

      In other words, ACA is a failure.

      1. It was going to “bend the cost curve”, provide healthcare for millions of people, we had to do it or our economy was going to collapse.

        Funny how all of that bullshit, all of the crying and the celebrations about how they had fixed the world all went down the memory hole. Now Obamacare is just this sort of okay thing that the Republicans forced on the country that needs to be built upon. It is defies comprehension how these people lie like they do.

        1. “Ryan (formally HFTO)
          July.16.2019 at 11:22 am
          True Obamacare has never been tried”

          Ryan was joking but I fully expect to hear that excuse.

    3. “”We have the Affordable Care Act (ACA) and we can build on that framework.”‘

      What was affordable about it?

    4. Nice Corporate Speak you got there.

    5. No – updating the ACA is just doing more of the same old stuck on stupid that we’ve been doing for 40+ years in health care. Our medical system is completely broken and the only way we are going to fix it is to take the blinders off everyone.

      55-60% of the population is covered by employers and they do not have the slightest clue about anything because 80% of their healthcare costs are subsidized so they have no freaking clue what anything actually costs. The ONLY solution is to eliminate the tax subsidy re employer-health that diverts compensation from salary to health-plans. Tax both sorts of income (salary and health insurance subsidy) the same. And eliminate the mandate for larger employers to provide health insurance.

      If ‘the market’ actually works as people who have employer-paid health insurance believe, then magical things will happen almost overnight and after at most a few weeks disruption everyone will be pleased as punch and ‘Medicare for All’ will lose all interest.

      If, as is more likely, the market doesn’t work for health care; then within about the same amount of time (a few weeks) people will realize what a cluster#$%@ it all is – but at least in that scenario EVERYONE will come to that realization so at least we can begin to see the forest rather than the individual weeds and branches.

      1. So we crash the existing government built house of cards and then the government will build us a shiny new one?

  12. Currently, people who make up to 400 percent of the poverty line, about $48,000 for an individual or about $100,000 for a family of four, are eligible to receive subsidies for coverage purchased through the law’s health insurance exchanges, insulating those people from much of the cost of coverage.

    That is a a gross misrepresentation of the facts. The subsidies are adjusted based on the income of the applicant. Someone making 380% of the poverty line (dependent on the family size) will get a way smaller subsidy than someone that makes 110% of the poverty line.

    When I was helping people sign up for coverage as a CAC, we would often run into families making about 270-350% of the poverty line, and they’d qualify for like $30-$100/month in subsidies on plans that cost upwards of $800/month for a family of 4. Meanwhile, some healthy twenty-something with zero kids and no spouse, working freelance making 120% of the poverty line gets hundreds in subsidies and only has to pay $8/month himself for coverage.

    Obamacare only helped a very small sliver of people barely making money above the poverty line. Everyone else- it fucked them by making their plan illegal, causing deductibles to skyrocket and causing otherwise healthy people to subsidize the health insurance market under threats of fines/prosecution.

    1. Meanwhile, some healthy twenty-something with zero kids and no spouse, working freelance making 120% of the poverty line gets hundreds in subsidies and only has to pay $8/month himself for coverage.

      Funny how forcing all those childless Millennials on to a health insurance plan was supposedly going to increase the pool of money available to take care of older, sicker people. Gee, can’t imagine why a bunch of Boomer politicians thought that Millennials were all making the wages of middle-aged Gen-Xers.

      1. It is mind blowing how this law shoots itself in the foot every step of the way.

  13. Obamacare doesn’t work? No shit?

    And here I thought that Democrats being kicked out of power over it across the country was just a fluke.

    1. It worked as well as it was expected to, by all parties.

  14. From the title, I was expecting a detailed and nuanced breakdown for why Biden’s plan somehow contradicted or undermined the original ACA framework. Instead, I found no solid evidence for the claim made in the title.

    This is disappointing, and I expect better from Reason.

    1. Hey, doofus, if Obamacare was working just swimmingly, Biden wouldn’t need to alter it, now would he?

      1. The Constitution has been amended 27 times, and I’m pretty sure nobody was saying that the Constitution “doesn’t work” each time that happened. Wanting to improve something does not necessarily invalidate it.

        This article provides no evidence for its claim.

  15. Maybe he should call it the Expensive as Fucking Hell Healthcare Act.. As anytime they call something a certain name the outcome is almost always the direct opposite of what the name implies. Thus reducing costs for real this time.

  16. The United States needs another government run healthcare plan like it needs the clap.

  17. I suppose they know best, but these guys would appeal better to me at least if they included caveats with all their policy proposals that they all depend on the makeup of Congress and other nods to practical reality.

    Biden is sort of saying that, but not explaining it. It’s more “noun, verb, Obama.”

    Of course I find myself on Team Unicorn Fart this time around since of the pragmatists, Biden is very old and Klobuchar is a psychopath.

  18. I thought Obamacare was designed to prevent rent seeking from people who felt they were immune from disease or injury and then found themselves in the ER on our dime. Fuuck those assholes!

    ACA is dead?!? Yay! But what’s this? Some zombie?

    https://www.healthcare.gov/

  19. two plausible avenues to ‘fix’ healthcare spending in the US:

    1. carrot and stick providers. cap their pay, but also define in statute their maximum liability if/when they fuck up. probably have to write off a lot of their debt too

    2. tell the 5% of the population that accounts for 50% of spending we’re sorry but we can’t afford this any more. He’s some morphine.

    not saying i’m sure these would work, but they are certainly more realistic than dicking around with insurance.

  20. […] plan was just too expensive. Former Vice President Joe Biden’s recently announced plan to expand Obamacare comes in around $750 billion over a decade—which, at more than three-quarters the cost of the initial legislation, makes for a […]

  21. […] plan was just too expensive. Former Vice President Joe Biden’s recently announced plan to expand Obamacare comes in around $750 billion over a decade—which, at more than three-quarters the cost of the initial legislation, makes […]

  22. […] care plan was just too expensive. Former Vice President Joe Biden’s recently announced plan to expand Obamacare comes in around $750 billion over a decade—which, at more than three-quarters the cost of the initial legislation, makes for a […]

  23. […] plan was just too expensive. Former Vice President Joe Biden’s recently announced plan to expand Obamacare comes in around $750 billion over a decade—which, at more than three-quarters the cost of the initial legislation, makes […]

  24. […] ideas Biden has nevertheless to reply about his plan. Reason’s Peter Suderman is also very right to position out that the extremely existence of Bidencare is an admission that Obamacare has unsuccessful to […]

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