Obamacare's slippery slope to single-payer system

  • CNBC | by: Peter J. Pitts |
  • 12/03/2015
UnitedHealth Group, the nation's largest health-insurance company, has threatened to pull out of the Affordable Care Act's exchanges in 2017, thanks to red ink. Other big insurers are reporting losses as well. The Affordable Care Act, either on purpose or through faulty construction, (depending on your taste for conspiracy theory) was designed to fail.

With Obamacare facing serious headwinds, it's imperative that regulators improve the quality of exchange plans to boost enrollment numbers. Failure to do so will only embolden those who wish to see it replaced with a single payer health-care system.

What's becoming obvious to patients, physicians, and payers is that under current ACA regulations, there's a stark difference between "having insurance" and "having access to health care."

To get around caps on how much they can charge in premiums, insurers have imposed higher out-of-pocket costs for many specialty drugs. The absurdly high co-pays and co-insurance mean that, in practice, many patients with exchange plans can't afford their medicines.

Just look at silver plans (the most popular category). In five of 20 drug classes for conditions from cancer to HIV, at least 20 percent of plans require patients to pay 30 percent or more of the medicine's cost. Over half of silver plans place all multiple sclerosis medicines in the "specialty tier" with the highest level of cost-sharing.

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