The American Spectator

Betsy McCaughey highlighted some salient points about how the Affordable Care Act (a.k.a Obamacare) will affect ordinary people in an address to the Heritage Foundation today. Her book, Beating Obamacare, is designed to help people anticipate and survive the changes to healthcare coming through this 2,572 page “law.”

The former lieutenant governor from the state of New York, a constitutional scholar and patient advocate, began solemnly: “Most Americans get their health insurance through a job… In the coming months they are going to be getting some bad news … many are going to be called into their employer’s office and hear the words, ‘I’m sorry but we’ve decided not to offer coverage any longer.’”

She cited new “one size fits all” federal coverage mandates as the culprit for rising prices, and anticipated that employers will either opt to pay the penalty, or push their workers down to a part time status that will save them from even paying the penalty.

Where will people go in this imminent situation? To the new state insurance exchanges, which, she promised, would be everywhere, even in states that ‘opt out’ of them. “It will be like going to a supermarket that only sells cereal…” she continued. “Ignore the differences between bronze, silver, gold and platinum … there won’t be any difference in actual care … just a smaller co-pay and a smaller deductible (if you spring for platinum).”

McCaughey went on to cite some parts of the law she expected would run into more legal resistance, including Section 1311, which “empowers the federal government to dictate how doctors should treat privately insured patients.” She anticipated it being challenged in court based on the Supreme Court case Gonzalez vs. Oregon—but not before it goes into effect in 2014.

She warned that the law gave tax incentives to hospitals that spent less per senior. She cited evidence from the Archives of Internal Medicine showing that reducing costs in such a fashion leads to a real rise in the hospital senior death rate, partly because hospitals realize the cuts by laying off nurses.

She also pointed out where the Act really gets more Americans healthcare coverage—vast expansions in Medicaid eligibility. Since this is a burden shared with the states, Dr. McCaughey speculated that many states were expecting to be saddled with the costs of this expansion, which is why a number of them are doing their best to opt out.

McCaughey proves herself to be one of the few who really understand the Affordable Care Act (although there are unconfirmed reports that Nancy Pelosi has finished reading it now). Her prognoses, though at times ominous, are at heart pragmatic, based on common-sense, and well-intentioned. The investment in her book, Beating Obamacare, will likely prove to be a wise decision many times over.