In the past three years, the Affordable Care Act, or Obamacare, has expanded free health insurance to millions of low income Americans and is helping pay the cost for millions more at taxpayer expense. However, it's no secret that for many others, premiums have skyrocketed, benefits have declined and they've lost their doctors.
Just this week, the administration revealed premiums will rise an average of 22% next year. In Arizona, the cost of some plans will increase 116% percent.
With enrollment for 2017 beginning Tuesday, Full Measure investigated and found that Obamacare is in Critical Condition and leaving a dire outlook for the nation's health insurance system.
Virginia health insurance broker Ed O'Brien helps match up customers with the right policies.
Ed O'Brien: It's not working. Clearly it's not working.
A task that's become much tougher, he says, under Obamacare.
O'Brien: Your average person who makes $30,000-$35,000 a year cannot afford a $10,000 premium and an out of pocket that's even higher than that. It's just simply not sustainable or affordable.
Cara Acker says Obamacare has been especially hard on her mother, who wasn't offered insurance at work.
Cara Acker: She had to personally purchase her own plan through insurance, through Obamacare, and she had diabetes and some health care concerns, and her plan was just, she could barely afford it, it was so unaffordable. They call it the affordable care act, but it was actually the opposite for her.
Robert Laszewski: You know what, I told them not to call this the affordable care act.
Sharyl Attkisson: You told who?
Robert Laszewski: The Obama administration. The Democrats. Every Democrat I could find.
Robert Laszewski is a policy adviser and analyst for the insurance industry. He's correctly predicted Obamacare's pitfalls since day one.
Robert Laszewski: The future is not good. The fundamental problem is not enough healthy people have signed up to pay for the sick, and not enough healthy people have signed up because the insurance plans that people are being offered just simply aren't of good value.
Sharyl Attkisson: What do customers see as wrong with the insurance product?
Robert Laszewski: The insurance products consumers see are still too expensive in terms of premium. And the deductibles and copays are too high.
Sharyl Attkisson: Can you explain in simple terms how the insurance companies are losing so much money if they're charging so much for premiums and if deductibles are so high?
Robert Laszewski: It's real simple. If you only provide a health insurance plan that the sickest people buy, you can't charge enough. You can never charge enough.
Ed O'Brien: The rates are getting such that people are just simply saying I'm not gonna have health insurance, and I'll pay the penalty because I just simply can't afford the premiums. I'll take the chances of being uninsured and pay the penalty, which defeats the purpose of the affordable care act.
Lena Simmons says she's lucky to have good insurance through her teaching job. She knows others facing a hard reality.
Lena Simmons: If you're working for a city job you have health care. But if you're working for a job in a pizza place or retail center, it's expensive for them to give you quality health care.
It's expensive, say experts, because nearly all of the government's plans to increase competition have backfired. Take the abysmal failure of the Obamacare co-ops: 23 nonprofits started up with your tax dollars. After sometimes paying exorbitant salaries to their executives, they've gone belly up one by one.
Robert Laszewski: There were 23 and 17 have gone broke so far.
Sharyl Attkisson: And that's our tax money that went down the tubes with it.
Robert Laszewski: About 3 billion dollars when it's all over, yeah.
For-profit insurance companies are jumping ship, too.
Robert Laszewski: Like Aetna, Humana, United Healthcare, some Blue Cross plans pulling back. A number of Blue Cross plans losing substantial amounts of money and having to go after major rate increases to stay in the business.
Earlier this month, Obamacare critics were surprised to hear agreement from an unlikely source: President Clinton on the stump for Hillary.
Bill Clinton: So you've got this crazy system where all of a sudden 25 million more people have health care and then the people who are out there busting it, sometimes 60 hours a week, wind up with their premiums doubled and their coverage cut in half. It's the craziest thing in the world.
The White House declined our interview request. President Obama continues to call the Affordable Care Act one of his administration's key successes.
President Obama: Because of Obamacare, another 20 million Americans now know the financial security of health insurance. So do another 3 million children and the net result is that never in American history has the uninsured rate been lower than it is today.
But just last week, the President concedes Obamacare suffers significant problems.
President Obama: The problem is, is that we have not reached everybody and pulled them in. And think about it. When one of these companies comes out with a new smartphone and it had a few bugs, what do they do? They fix it. They upgrade unless it catches fire, and they just (laughter) then they pull it off the market.
Sharyl Attkisson: Is it true that more people have health insurance today as a result of the Obamacare plans?
Robert Laszewski: It is true that more people have health insurance today because of Obamacare. Particularly because of the Medicaid expansion in the 31 states that have taken it.
Richard Fuertes says he's delighted by the options available in the U.S. compared to where he comes from in the Philippines.
Richard Fuertes: I'm really thankful. I appreciate it for myself that's what I'm saying for me.
Obamacare has also opened up affordable insurance to many with pre-existing medical conditions. Illnesses that once made it impossible for some to get affordable insurance.
Ed O'Brien: A lot of people were able to get insurance that couldn't get it before because they had pre-existing conditions. So I suppose in some respects that was a good thing. Unfortunately, these preexisting conditions which aren't looked at any longer have caused insurance rates to go up at catastrophic rates.
In the insurance industry, it's called the Death Spiral not enough healthy people sign up to pay for the sick. Premiums have to go up. So more healthy people drop their insurance. Premiums for those left have to go up again.
Robert Laszewski: The lowest income people in Obamacare are the ones that benefit the most. They get the highest subsidies and their deductibles and their copays get subsidized. So if you look at the very lowest income people in Obamacare, 82-percent of them have signed up. That's terrific. That's a terrific pool. But then if you look at the people between 3 and 400-percent of poverty, the people that start moving up toward middle incomes inas, as a comparison, only 17-percent of them have signed up. So I think part of this program is in a death spiral already.
Earlier this month, Minnesota Governor Mark Dayton, a Democrat, backed off his staunch support of Obamacare after sticker shock cases like one family of four learning they'll have to pay $40,000 in premiums next year, with a $13,000 deductible.
Mark Dayton: Ultimately I'm not trying to pass the buck here but the reality is the Affordable Care Act is no longer affordable.
Sharyl Attkisson: At its core, it was supposed to provide affordable insurance for everybody who needed it.
Robert Laszewski: Yes. The Affordable Care Act was supposed to ensure that whether you were employed or unemployed or self-employed, you would have access to affordable health insurance. For someone who's not getting a subsidy, who's paying the full cost of insurance, it's, it's likely that they're now paying about double what they paid before under the old market, where only healthy people could get in.
Cara Acker: Anytime you make a law that forces someone to spend their hard earned money on something it gets pretty tough. We're just not in a, I think as a whole as a country, we're just not in a place where we can be told we have to spend that many hundreds and hundreds of dollars each month, especially if you have multiple people in your family. It's a huge sacrifice.
Laszewski and other experts say Obamacare is already a failed experiment and predict that, without a major fix, it will "implode" by the end of next year.
