As Trump weighs veto, Obamacare’s flaws come due

By Greg Schaller 
Real Clear Wire

As the cost of living continues to climb, a new financial burden is quickly threatening millions of Americans: increased health care premiums.

This past weekend, President Trump announced that he is considering vetoing legislation to extend federal health insurance subsidies established by the Affordable Care Act (ACA). While many will portray Trump as the villain in this scenario, it is actually the political leaders who prefer receiving praise for well-intentioned policies without ever accepting responsibility for the burdens they create. 

Renowned economist and academic Thomas Sowell, in his book “The Vision of the Anointed,” describes this problem as a recurring pattern in progressive policymaking: a cycle of moral self-congratulation and denial.

It unfolds predictably: A crisis is declared. The “anointed” identify a social ill – be it poverty, crime, education, or health care – and demand urgent and excessively ambitious government action. Moral stakes are dramatized; hesitation is cast as heartless. A solution is imposed. Sweeping policies are presented as enlightened and inevitable. Critics are not merely wrong but morally suspect, “simplistic,” “ideological,” or “dishonest.”

Then reality intrudes. Promised benefits fail to appear, costs soar, and incentives are distorted. Finally, failure is redefined. When outcomes disappoint, the anointed insist things would have been worse without intervention. The only mistake, they claim, is that government didn’t go far enough and not enough control and money were granted to the state.

For Sowell, this is not an accident but the operating logic of modern progressivism: a worldview immune to evidence and accountability. Nowhere is it clearer than in the case of the ACA, the crown jewel of Barack Obama’s domestic agenda and a textbook instance of Sowell’s “vision of the anointed.”

When proposed in 2009, the American health care system was undeniably troubled: Costs outpaced inflation, millions were uninsured, and coverage was often tied to employment. The Obama administration framed this as a national emergency. “We can’t wait,” the president warned, urging swift congressional action.

The proposed solution came wrapped in moral urgency and impractical economics. Americans were told they could keep their doctor, keep their plan, and save $2,500 a year on premiums. The law would “bend the cost curve,” expand access, and make health care more secure. Skeptics were accused of cruelty or cynicism, charged with defending a broken status quo for ideological reasons.

The ACA did expand coverage, largely through Medicaid and income-based subsidies. But nearly every other promise collapsed on contact with reality. Premiums and deductibles rose sharply; the Department of Health and Human Services reported that average benchmark premiums more than doubled between 2013 and 2017. Many insurers fled the exchanges, leaving some regions with only one option, hardly the “competition” that was promised. Millions lost plans they had been told they could keep.

Instead of “bending the cost curve” downward, the ACA bent it upward. Total national health expenditures kept climbing, while federal subsidies ballooned to keep plans remotely affordable. The law’s mandates, regulations, and guaranteed-issue rules deepened the system’s detachment from price signals and consumer choice, the very mechanisms that could have contained costs.

In short, the ACA made health care neither affordable nor sustainable. It succeeded mainly in expanding bureaucratic control and government dependency. Yet to the anointed, none of this counts as failure. They argue instead that the ACA simply didn’t go far enough. If premiums are high, it’s because private insurers remain. If subsidies are costly, it’s because funding was too low. If the system is dysfunctional, it’s because government power is still incomplete. So now its architects demand single-payer options – the very outcome critics warned against.

The problem is never the policy itself but its insufficient implementation. As Sowell observed, no evidence is ever sufficient to change the vision. Every failure becomes an argument for more of the same.

Why does this pattern endure? Sowell’s answer is a morality tale, not economics. The anointed see themselves as the compassionate and rational elite, those who care more and know better. Their authority rests on moral posture, not empirical success. To admit failure would mean surrendering that moral privilege.

This is why the ACA’s failures have not discredited the progressive model but reinforced it. Having created a more expensive and unstable system, progressives now insist that the only solution is to eliminate market competition entirely. “Medicare for All” is not a break from the ACA’s logic, it is its inevitable conclusion.

Sowell ended “The Vision of the Anointed” with a sober warning: Until citizens reject this pattern, until we demand accountability rather than moral theater, the cycle will continue. Policymakers will keep declaring crises, imposing solutions, redefining failure, and moving to the next crusade.

The lesson of the Affordable Care Act is not merely that one law failed, but that good intentions detached from reality can produce lasting harm. The moral high ground claimed by the anointed often becomes a mire of unintended consequences.

If Americans truly want affordable, accessible health care, we must look beyond the grand designs of political visionaries and return to the hard discipline of economics, competition, transparency, and personal responsibility. That means not more government power, but less. As Sowell might put it, the first step to recovery is to stop believing the anointed every time they cry “crisis.” We’ve seen this movie before. And we already know how it ends.

Greg Schaller is director of the Centennial Institute, conservative think tank of Colorado Christian University.

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