Did Obama break the law to save the Affordable Care Act?

Recently, a federal audit found that the Obama administration has illegally redirected funds related to collections from the Affordable Care Act that, by law, should have been deposited in the U.S. Treasury. President Obama, under the guise of executive order, used these tax dollars to bail out insurance companies that have experienced hundreds of millions of dollars in losses due to their participation the Affordable Care Act (ACA) exchanges.

In their report, auditors state that the Obama administration, “ignored the statutory requirement to collect funds for the Treasury.” As you might expect, the president defended his actions by arguing that it was necessary to direct these funds to insurers in order to offset the increasing costs (and rising premiums) of the Affordable Care Act. Unfortunately for taxpayers, the U.S. Government Accountability Office, the agency responsible for this audit, has no legal authority to enforce its findings or legal opinions.

This latest report is just another example of how the president’s devotion to a failed policy continues to hurt the American people. Even with the diversion of tax dollars to insurance companies by Obama, premiums continue to rise an average of 25% with some states reporting nearly 50% increases for some plans. As these premiums rise, covered services and access to care have begun to dwindle. Competition in the exchanges is nearly non-existent in some states — patients are beginning to realize that they have very little choice in insurance companies. Many shoppers are unable to compare prices due to the fact that only one company is represented in the exchange marketplace in their state.

Recently, the New York Times finally admitted that unless changes are made, the ACA is unlikely to be sustainable. While neither candidate has spent very much time discussing health care (no mention in the first debate), health care and the ACA will definitely change based on who becomes the next president. Hillary Clinton wants to expand government involvement in health care resulting in a single-payer system — Medicare for all. Donald Trump, by contrast, suggests that less government involvement will be the answer. Trump advocates for more free-market competition, essentially allowing insurance companies to compete for subscribers across state lines.

When the marketplace opens for its fourth year of enrollment in November, consumers will be greeted with higher premiums and fewer choices. Major players such as United, Aetna, and Humana have significantly limited their participation in the exchanges due to mounting financial losses. Many nonprofit cooperatives have closed down. The basic premise of the ACA is that young and healthy enrollees would help pay for older, sicker enrollees who would require more care and more health care dollars. Unfortunately, for Obama and his legacy, two things (that I and others predicted) happened:

  1. Older patients with multiple medical problems enrolled in the exchanges in record numbers. This has placed an enormous financial burden on the Federal government and the insurers that participated in the ACA.
  2. Fewer young healthy patients have enrolled in the ACA than originally expected. This has resulted in a premium shortfall in many cases. Insurers are “upside down” in the ACA and pulling out.

Ultimately, the ACA is a bad law. While insurance for all is a noble goal, it must be accomplished in a way that is fiscally responsible and in a way that allows doctors to practice responsible evidence-based medicine. It is disturbing that our president has manipulated tax dollars (redirected them outside the law) in order to buffer his signature legislation rather than work with Congress to actively overhaul a broken law.

Kevin R. Campbell is a cardiac electrophysiologist who blogs at his self-titled site, Dr. Kevin R. Campbell, MD. He is the author of Women and Cardiovascular Disease.

Image credit: Shutterstock.com

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