When ObamaCare turns eight on Friday, the law will have exactly one impressive accomplishment to its name: surviving as long as it has.
Americans are worse off than we were before ObamaCare was enacted. Health insurance premiums and deductibles are soaring, and consumers face a shrinking number of insurance options. More Americans than ever are now covered by Medicaid – a costly and unsustainable entitlement that, in many cases, is worse for patients' health than going without insurance altogether. And U.S. life expectancy has dropped for two consecutive years for the first time in over half a century. ObamaCare bears much of the blame for this disastrous state of affairs.
The Affordable Care Act's most glaring shortcoming has been a failure to make good on its eponymous promise – affordability. President Obama assured Americans in 2010 that the law's insurance exchanges would create "a competitive marketplace" where Americans could "purchase affordable, quality insurance."
On the HealthCare.gov marketplace, however, average premiums in 2017 were 25 percent higher than in 2016 – and more than double average individual-market premiums in 2013. Premiums have continued to soar this year – midlevel Silver Plan premiums increased by an average of 34 percent in 2018, relative to 2017.
Out-of-pocket costs have skyrocketed as well. The average deductible for an individual Silver Plan this year was nearly $4,000.
The combination of high premiums and high deductibles has put health care out of reach for millions. In a June survey, one-quarter of Americans said that they or someone in their family had gone without needed medical care because of cost.
Nor have the exchanges been especially competitive. ObamaCare's mandates have cost insurers hundreds of millions of dollars. Insurers have responded by fleeing the marketplaces in droves. Over half of U.S. counties currently have only one provider selling exchange coverage.
ObamaCare's defenders have long cited the drop in the uninsured rate as proof of the law's success, but that argument no longer holds water. The number of uninsured Americans actually increased by 3.2 million last year, in part because ObamaCare has made insurance so expensive.
The law has also managed to funnel 15 million new patients into Medicaid – the health insurance entitlement for low-income Americans. But it's far from clear whether that's a blessing or a curse for new enrollees.
Medicaid beneficiaries are no healthier than uninsured people. One recent study compared uninsured Oregon patients with a group that was randomly selected to receive Medicaid. After two years, researchers found "no significant improvements in measured physical health outcomes" among Medicaid patients compared to their uninsured counterparts.
Worse, the Medicaid expansion has exacerbated our nation's deadly opioid epidemic – at least according to a recent report from the Senate Homeland Security Committee. The expansion made prescription painkillers cheaper and more widely available. People who were eager to abuse these medications – or sell them illegally on the black market – quickly capitalized on this new government-subsidized drug supply.
Medicaid fraud cases related to opioids have increased by 55 percent since ObamaCare's expansion of the program. Eighty percent of fraud cases have been filed in expansion states. Even more troubling, overdose death rates are rising nearly twice as fast in Medicaid expansion states as in non-expansion states.
Since ObamaCare took effect, insurance coverage has become more expensive, out-of-pocket costs are more onerous, insurance choices have dwindled and Americans are dying sooner. Let's hope the law's eighth birthday is its last.