Proponents of the Affordable Care Act continue to believe health care reform is working, albeit now with some qualifiers. Paul Krugman is one of the biggest champions of everything Obama. In a recent op-ed, he opines that “health care reform is still a huge success story” in spite of a “few rough patches lately” which are “much less significant than a lot of the reporting…would have you believe.” He spins the “rough patches” in such a way that the reader is left to believe these were actually planned and anticipated by the architects of the law. 

To put them in perspective, however, let’s go back to 2010 when the law began and what the American public was told at the time. (here) 

First of all, the country was told that Obamacare would provide universal health insurance. At the time, 50 million Americans for one reason or another went without health insurance. To date, 30 million still do not have insurance. Krugman now writes that “nobody ever expected Obamcare to cover all of the uninsured.” So, reach 40 percent of your goal and call it a success. 

Also, half of these newly insured people were forced into Medicaid, a health insurance entitlement that for most people provides no better clinical outcomes than being uninsured. (here) 

Second, Obamacare was designed to bend down the increasing cost curve of health care. Remember when the president went on record stating that families would see their insurance premiums go down $2,500 a year. Krugman admits that premiums on average across the nation will go up 11 percent next year, but rationalizes that it’s “a slight disappointment” and anyway “the long-term tendency of insurance premiums (is) to rise 5-10 percent a year.” 

In addition, the original ACA budget was $940 billion over ten years. The Congressional Budget Office subsequently revised that budget to $1.7 trillion over ten years. So much for bending the cost curve down. 

Third, Americans were told repeatedly that “if you like your current health insurance, you can keep it.”  Krugman and other proponents have simply stopped talking about this point. In Washington state alone, 290,000 people were forced off their original insurance and had to find new policies. 

Fourth, the individual mandate in the ACA was designed to force every adult over the age of 17 to buy health insurance. To make Obamacare work, the law needs young, healthy adults to pay for sicker, older people. No surprise, young adults are making an economic decision to pay the penalty tax and buy health insurance only after they become ill. 

Consequently, overall, fewer people are using the health insurance exchanges to purchase insurance. Krugman, an economist, again spins this fact and writes that “the main reason is that surprisingly fewer employers are dropping coverage.”  This may be true, but doesn’t address the issue of young adults not buying health insurance. What has actually happened since the exchanges opened in 2014 is that sicker individuals have stayed in the exchanges and healthy people have either not signed up or have dropped out. 

Krugman writes that we are not seeing a “death spiral”, but that we are seeing “an imperfect system (that is) working.” He goes on to chide those people who “have been predicting disaster every step of the way … and will still be predicting imminent collapse a decade from now.” 

From the beginning, Obamacare was a 2,700 page Frankenstein monster that passed with a strict partisan vote and with limited support of the American public. In spite of the spin, Obamacare works for certain people, but remains a drag on the U.S. health care system. Krugman is being optimistic to believe Obamacare will still be around in a decade.