ACA not at fault in healthcare crisis, experts say

Insiders disagree that Obamacare caused all the consolidations that raised prices.

- By JULIE APPLEBY

SENATE Republicans have resurfaced old criticisms of the Affordable Care Act.

(CHIP SOMODEVILLA Getty Images)

In a recent Meet the Press appearance, Sen. James Lankford (R-Okla.) joined a growing number of Republicans who are speaking out against Obamacare. One of his lines of attack: that the Affordable Care Act fueled healthcare consolidation.

“What Democrats did 15 years ago was they radically changed all healthcare in America. They moved all physicians under hospitals. They changed all the reimbursement programs. They shifted everything in,” Lankford said Nov. 9.

This is one of a collection of Republican talking points related to the ACA that’s been regularly reprised, and there's a reason for it.

Democrats have been promised a Senate vote this month on whether to extend the ACA’s enhanced subsidies, set to expire at year’s end. The debate, however, has given Republicans an opportunity to resurface old criticisms and reignite efforts to overhaul or even undo the ACA.

One GOP argument is that the sweeping health law fueled industry consolidation, which has led to higher prices and pushed more doctors to sell their practices to hospitals or insurers.

But industry experts disagree about how much this market trend can be tied to the law known as Obamacare.

Like everything in health policy, it's complicated.

“Most of us live in a different reality,” said Chip Kahn, president and chief executive of the Federation of American Hospitals, which supports extending the enhanced tax credits. “Our health system has many challenges, and I can’t say the cost to individuals, to taxpayers, is not an issue. But to say having better coverage for more people made all these problems worse is really a stretch.”

First, some context. The ACA was passed by Congress in 2010, and most of its major provisions became effective in 2014.