An key argument peddled in defense of ObamaCare goes something like this:
Trump reiterated that he'd like to keep two of the law's most popular provisions: letting children up to the age of 26 stay on their parents' insurance, and forbidding insurers from discriminating against people with pre-existing conditions, like cancer or diabetes.
The challenge is the second one. Not even Trump wants to return to the dark days when insurers refused to cover breast cancer survivors, or charged them sky-high premiums they couldn't afford. But most experts say it's impossible to keep this protection if you repeal the rest of Obamacare - the individual mandate that orders everyone to buy insurance, and the subsidies that help low-income, healthy people join the rolls.
Think about what will happen. If people aren't required to buy insurance, but know they can get it if they fall ill, many of them will save money by buying coverage only after they get sick. That would deprive insurers of premiums they need to cover their costs, forcing them to increase premiums dramatically. That, in turn, would prompt even more healthy people to quit buying insurance, a trend experts call the "death spiral
His proposal to turn Medicaid into block grants would only shift the burden of paying for the very poorest citizens to the states.
It's not clear that would even save money in the end. Because people without insurance would land in emergency rooms, where both the law and the dictates of human decency require hospitals to provide. Those hospitals then get help from the state through a program known as "charity care."
Those quotes are not made up. They are from a New Jersey Star-Ledger editorial from November 2016, before Trump took office. In Trumpcare': Kicking 22 million off health insurance?, The Star-Ledger sums it up: “In other words, we pay either way.”
I left these comments, edited for clarity:
And why is that? Because “either way,” the government forces “we” to pay. Welcome to the welfare state—the slow bleed toward totalitarian socialism. Statists have saddled us with so many wealth redistribution schemes that no one can escape being forced to pay for others’ needs. Western socialists discovered long ago that the communist path to socialism wouldn’t work in the West. So they adopted the backdoor approach—fascism. Fascism is socialism without government ownership. As the infamous leader of Germany’s National Socialist Workers Party explained about 8 decades ago:
“Each activity and each need of the individual will thereby be regulated by the party as the representative of the general good…This is Socialism- not such trifles as the private possession of the means of production. Of what importance is that if I range men firmly within a discipline they cannot escape? Let them own land or factories as much as they please. The decisive factor is that the State, through the party, is supreme over all, regardless of whether they are owners or workers…Our Socialism goes far deeper…[the people] have entered a new relation…What are ownership and income to that? Why need we trouble to socialize banks and factories? We socialize human beings.” [From Herman Rauschning’s The Voice of Destruction, as quoted in The Ominous Parallels, by Leonard Peikoff, page 231-232.]
If “we pay either way,” we are on our way to being fully trapped “firmly within a discipline we cannot escape.” We’re already part way there, and with each new welfare state expansion—ObamaCare created a whole new class of parasites—we’re told we can’t repeal it because “we pay either way.” Trapped.
That’s why, in order to repeal and replace ObamaCare, we must challenge the very concept of the regulatory welfare state and the forced redistribution of wealth that it rests on. To do that, we need to protect each individual’s right to decide for himself who, when, how, and in what capacity to help others. Government has no legitimate role in charity.
Abolishing the welfare state can’t be done overnight. It must be done slowly but systematically to give people time to adjust back to freedom and individual rights and the self-responsibility that goes with it. A good place to start is with the repeal of the pre-existing conditions mandate, the heart of ObamaCare. To do that, we must remove the biggest cause of pre-existing conditions, the third-party-payer system, and replace it with individual ownership of insurance like life, auto, and homeowners. We must also repeal all of the insurance mandates, which drive up the cost for everyone and bars insurers from selling new policies that exclude, charge more for, or include delayed coverage for pre-existing conditions. These regulations leave people with pre-existing conditions with no insurance for anything because of a single condition. There are plenty of other free market reforms needed, like insurance riders that specifically cover pre-existing conditions, enabling people who lose or change insurance carriers to get new coverage without losing coverage for their pre-existing condition.
This is just a sample of the reforms we need. Health insurance is morally a matter between consumers, providers, and insurers that government coercion shouldn’t interfere with. People should be free to shop for the coverage that best suits their needs and wallets from competing insurers, rather than be forced into overpriced government-mandated policies. But that won’t even happen. Trump has already said he will keep the pre-existing mandate. He is a center-left, big spending welfare state liberal, after all. We’ll end up with TrumpCare, which will essentially be ObamaCare without Obama with a dash more healthcare freedom scattered here or there. Trump will not reverse the statist trend, and we will continue down the path toward a government-imposed discipline we cannot escape. I don’t know what the Left is so worried about.
The Road To Socialized Medicine Is Paved With Pre-existing Conditions—Yaron Brook and Don Watkins