by Richard A. Epstein
Hoover Institution
April 22, 2014
Enrollment is only the first step for the Affordable Care Act (ACA). A sound evaluation of the program must explain how, over its entire life-cycle, it can overcome all of the theoretical objections about its design. There are all sorts of ways to keep young adults on their parents’ policies, to improve Medicare reimbursement systems, to extend Medicaid, and to deal with preexisting conditions, without also turning the private individual and employer market upside down. Yet the ACA’s centerpiece—the individual and employer mandates—disrupts the market in major ways. The President derides his critics for their inability to come up with a viable alternative. But, the ACA designers failed to examine other alternatives, such as reducing regulations and permitting interstate sales of private insurance, that could have increased health-care competition. The ACA’s system of compulsion backed by a bevy of special taxes and fee regulations will cause the system to crash.

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