Health Reform Iceberg: Titanic Images

Obamacare is like an iceberg. The federal government's tab is merely the observable tip. The bulk of the costs - to individuals, businesses and the states - are hidden.

Sally Pipes, President and CEO, Pacific Research Institute, “States Fight Obamacare,” San Francisco Chronicle, September 8, 2010

“Iceberg” is a useful metaphor.

It evokes images of the Titanic, of 90% of dangers lurking below the surface, of unforeseen adverse consequences, of things not being what they seem, of helpless victims drowning in debt, and of states, businesses, and individuals being negatively impacted by Obamacare.

The new health reform law, now dubbed the Affordable Care Act, over 2400 pages long, is just being read and digested by states, businesses, and individuals. They are beginning to calculate what it will cost them, and they do like what they see. Those affected include budget officials in 50 states, 10 to 15 million business owners, and 265 million insured Americans covered by existing policies.

The states must absorb much of the new costs of additional Medicaid recipients, some 16 million of them coming on board in 2014, and struggling to adjust to the insurance reforms necessary to comply with federal mandates. In many states, current Medicaid costs are bankrupting their budgets. In Florida, Medicaid consumes 25% of its budget, the Obamacare will double the costs. And that does not include administrative and enforcement expenses necessary to comply with federal mandates. The result is more than 20 state attorney generals are challenging the constitutionality and practicality of these mandates. To the states, the federal part of Obamacare is just the tip of an Iceberg.

Federal officials and health plan experts are estimating costs this year will drive premium costs up to 9% this year and by an average of 6.7% each year over the next ten years. So much for the “affordability” portion of the “Affordability and Protection Act” and for 265 million Americans just beginning to take on water from the Obamacare iceberg.

For individuals the main costs of Obamacare will not only be increased premiums, particularly for those with individual policies and for small businesses with less than 50 employees, but loss of individual freedoms.

These freedoms include loss of current policies, which come up for renewal in 2011. They will have to drop those policies that do not meet Washington’s definition of what is “acceptable” health insurance. These loss of freedoms include loss of the ability not to buy health insurance should one feel they do not need health insurance.

Many perceive the tip of the iceberg may be President Obama himself. Many voters now see him as riding above the surface - cold, detached, cerebral with titanic thoughts. But the tip is not detached from iceberg main mass below. States, businesses, and individuals below are hurting, and they are asking - "What about me?" What about those of us drowning in debt?"