Obamacare is not primarily an entitlement program. The entitlement component \u201d\u201d the exchange subsidies \u201d\u201d will involve about 2 percent of Americans during the first year. (Others will be added to Medicaid, which has been around since 1965.) About 20 million Americans will eventually get subsidized insurance \u201d\u201d a check that goes not to the individual but to insurance companies. The remaining 170 million Americans will not experience Obama\u00c2\u00adcare as a sugary treat but as a series of complex regulatory changes that may make their existing insurance more costly, less generous and less secure.<\/p>\n
The main problem with Obamacare is not its addictive generosity; it is its poor, unsustainable design. Its finances depend on forcing large numbers of young and healthy people to buy insurance \u201d\u201d yet it makes their insurance more costly and securing coverage less urgent. (Because you can get coverage during each year\u2019s enrollment period at the same price whether you\u2019re healthy or sick, the incentive to buy coverage when healthy is much diminished.)<\/p>\n
Heavy insurance regulations will lead some employers to restructure their plans, dump employees into the public exchanges or make greater use of part-time workers. In order to meet a few worthy goals \u201d\u201d helping the poor buy insurance and covering preexisting conditions \u201d\u201d Obamacare seems destined to destabilize much of our current health system.<\/p>\n