Circum Election Obamacare Schadenfreude

This collection of Obamacare Schadenfreude covers a time span both before and after the election, so some (in fact many) of the articles need to be considered with that seismic shock in mind. Of course, with the election of the Donald Trump, and the retention of both houses of Congress by the Republicans, the Pubs have a real mandate for revisiting Obamacare.  Health Care Industry Braces For Repeal Of Obamacare. Repeal and replace is the mantra but the sometimes sensible Megan McArdle has a different idea (brought to you via Wombat-sochos "In The Mailbox: 11.09.16"): Repeal Would Be Even Worse Than Obamacare

I have no doubt that Republicans would like to vote for something they can call “repealing Obamacare.” The problem is that repealing Obamacare will involve getting rid of two provisions that are really, really popular: “guaranteed issue” (insurers can’t refuse to sell insurance to someone because of their health status) and “community rating” (insurers can’t agree to sell a policy to some undesirable customer for a million dollars a year; the company has to sell to everyone in a given age group at the same price).

These two provisions are consistently popular with voters across the spectrum. Unfortunately, they tend to send health insurance markets into what’s known as a “death spiral”: People know they can always buy insurance if they get sick, so a lot of them don’t buy insurance until they get sick. Because the sick people are really expensive to cover, insurers have to raise the price of the insurance, which means that the healthiest people left in the pool drop their insurance, which means the price of the insurance goes up. … After a few rounds of this, everyone has a guaranteed right to buy insurance -- but the sticker price is astronomical.

Obamacare is built to counter this problem -- with subsidies to bring down the price for many Americans, with a mandate for individuals to buy insurance or face tax penalties, with rules on enrollment timing to complicate "gaming the system." These are the unpopular parts of Obamacare.

Repeal will involve getting rid of the unpopular bits. But it will also involve getting rid of the popular bits. Republicans will be under enormous pressure to repeal just the unpopular parts, which would, of course, make the individual market even more dysfunctional than it is now. I wish good luck to President Trump or to any member of Congress who explains to voters that if they want the popular parts, they need the unpopular parts too. Believe me, I’ve tried.
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So I am skeptical that Obamacare will be repealed immediately. What might Republicans do instead?

The most obvious answer is: Wait for it to die a natural death. While Trump will not be pushing particularly hard for repeal, he will probably not be pushing to save Obamacare either. There will be no special deals for insurers who stick with the exchanges. His Department of Health and Human Services is not going to have a crack team devoted to coming up with ingenious regulatory tricks and dodgy funding mechanisms to make the exchanges work. Obamacare’s market structure is so deeply flawed that even benign neglect will probably prove fatal in fairly short order.

That's part of the problem with creating a new mandate. You create new government clients who, not shockingly, want someone else, somewhere (fat cats on Wall Street usually) to pay the bulk of the costs. I'm very pessimistic about the chances for completely repealing and replacing the system with a more rationale system, but Donald could accelerate the decline by repealing the executive orders that supported the law. Megan is similarly pessimistic about tweaking the existing law: A ‘Tweak’ to Fix Obamacare? That’s a Red Flag

Election 2016: it all started with Obamacare. It started and stayed unpopular, and yes, it fed the discontent that led to Trump. ObamaCare’s Chickens Come Home to Roost, and roost they did. Obamacare, the Last Straw. Did it cost Hillary the election? In a close finish, everything mattered.

So how has the law been faring lately? Here’s how the impending ObamaCare disaster affects you, Inside the Affordable Care Act’s Arizona Meltdown - Nearly every county in the state now has only one insurer selling plans through the health-care law’s exchange, and premiums are soaring. Trump took Arizona.

Providers continue to drop out in droves. With insurers pulling out of markets, some Obamacare users "really nervous" and Number of doctors participating in Obamacare plummets nearly 20%. More Megan: Anthem Threat Highlights Obamacare’s Big Test. Aetna exec sees ACA risk-adjustment death spiral If only someone would have warned them!

Prices continue to spiral, pushing people out: These Patients Are Covered by Obamacare But Can’t Afford Treatment,  CNN: ObamaCare stinks for the middle class, you know,  About that misleading 85% factoid about Obamacare subsidies, Obamacare Victims Revolt: ‘We Don’t have that Kind of Money’, Middle-Income Americans Take The Biggest Hit With Obamacare, and  Obamacare enrollee takes out 2nd mortgage to cover cost of his plan:

As Obamacare supporters would tell it, John is one of Obamcare’s success stories, i.e. he’s one of the millions of people now getting “high-quality, affordable” insurance on the exchange. But it’s doubtful that John would see it that way. Maybe initially he would have but once he was taking out a new mortgage to cover the cost of his mandatory insurance plan with $12,000 deductible, I sort of doubt it.

4 Reasons Obamacare Is Also A Lemon For People With Pre-Existing Conditions

1. Limited Access to Doctors
2. Restrictions on Drug Coverage
3. High Deductibles and Co-Pays
4. Loss of State High-Risk Pools

 Disaster averted: Tim Kaine said “Hillary Will Modify Obamacare To Include Gun-Addiction Therapy” Who put Tim Kaine and Hillary Clinton in charge of creating new mental illnesses to put on their political opponents?