ObamaCare: Miscalculated Assurances

Whether ObamaCare succeeds in attaining its lofty ambition to transform the financing and delivery of health care is problematic. Much depends on the results of upcoming congressional and presidential elections. Driven by national imperatives to extend coverage to the uninsured and to modernize outdated efficiency and quality improvement methods, the Obama administration prevailed in enacting the Affordable Care Act despite widespread voter misgivings, which it assumes will dissipate as the benefits of reform become more familiar-especially the ending of personal anxieties over the affordability and security of health insurance coverage. However, assurances made during the preenactment and postenactment stages may backfire. Not only is the Affordable Care Act unlikely to bend the cost curve downward as promised, but the majority of individuals not benefiting immediately will, contrary to assurances, encounter highly unpopular dislocations in preferred modes of health care.