Health care dreams turned to nightmares quick

They Lied



(instrumental intro)

(Verse 1 - Spoken, fast-paced like a rant over twangy guitar riff)

Yeah, gather 'round folks, let me tell ya 'bout the scam,

They called it Affordable, but it was just a sham.

Obama stood tall, looked us in the eye,

"If you like your plan, you can keep it," what a lie!

Promised premiums droppin' two grand a year,

But they doubled up, leavin' us in fear.

Said it wouldn't add a dime to the deficit pile,

But billions wasted, yeah, that's their style.

(Chorus - Sung, drivin' country rock beat, with harmonica wail)

They lied... and they knew it!

Pushed it through Congress, no truth to it!

Health care dreams turned to nightmares quick,

They lied... and they knew it!

(Verse 2 - Spoken, buildin' intensity with drum kicks)

Millions lost their coverage, plans gone in the wind,

Co-ops crashin' down, two billion down the drain.

Narrow networks squeezin', docs turnin' away,

Wait times stretchin' longer, every single day.

Subsidies for the healthy, deficits on the rise,

Emergency rooms packed, what a big surprise.

They said it'd fix it all, but it broke us instead,

Centralized mess, leavin' folks for dead.

(Chorus - Sung, louder, with electric guitar solo tease)

They lied... and they knew it!

No Republican buy-in, just Democrat bullsh*t!

Premiums sky-high, deductibles too,

They lied... and they knew it!

(Verse 3 - Spoken, conspiratorial tone, slower build)

Then comes Roberts, Chief Justice on the bench,

Started with the conservatives, ready to quench.

But he flipped the script, called the mandate a tax,

Saved their sorry law, covered their tracks.

Said it wasn't commerce, but hey, it's a fee,

Strange maneuver, brother, don't you see?

Protected the Court, or so they claim,

But we got screwed in this political game.

(instrumental solo) 

(Bridge - Spoken word over heavy bass and country fiddle)

Now premiums doublin', from two-three-two to five-one-five,

Twenty-four percent hike, man, how do we survive?

Unsubsidized families payin' through the nose,

Costs climbin' faster than anyone knows.

Expirin' credits, premiums up thirty more,

From eight-eighty-eight to nineteen-hundred, slammin' the door.

It's not about care, it's the insurance sting,

They built this beast, now hear the people sing!

(Chorus - Sung, full band blast, repeat and fade)

They lied... and they knew it!

Broke promises stackin', no end to it!

ACA failures, costs out of sight,

They lied... and they knew it!

Yeah, they lied... and they knew it!

(driving instrumental outro - fades)

Failures of the Affordable Care Act

The Affordable Care Act (ACA), also known as Obamacare, was intended to expand health insurance coverage, lower costs, and improve access to care, but it has been criticized for falling short on many fronts. One major failure is the disruption to existing insurance plans, with millions of Americans losing their previous coverage despite assurances otherwise, leading to higher premiums and deductibles while reducing consumer choices. Enrollment in the ACA's exchanges has been about 60% below initial projections, while Medicaid enrollment surged, contributing to issues like longer waiting times for care and slower ambulance response times in expansion states. The law has also driven up federal deficits through inefficient spending, such as subsidies for relatively healthy enrollees that inflated costs without proportional benefits. Programs like the Center for Medicare and Medicaid Innovation (CMMI), meant to reduce spending, instead increased federal outlays by $5.4 billion in its first decade, contrary to expectations of savings. Additionally, 19 out of 23 taxpayer-funded insurance co-ops collapsed, leaving millions scrambling for new coverage and wasting $2.4 billion in loans. Narrow provider networks and high out-of-pocket costs have persisted, limiting access to specialists and increasing financial hardship for many, particularly low-income groups. Overall, the ACA's reliance on mandates and subsidies has been faulted for lacking free-market principles, resulting in a centralized system that failed to deliver on cost control and broad accessibility.

Lies Told to Get It Passed in Congress

To secure passage of the ACA in 2010 without Republican support, proponents made several claims that later proved misleading or false. The most prominent was President Obama's repeated assurance: "If you like your health care plan, you'll be able to keep your health care plan, period." This was named PolitiFact's Lie of the Year in 2013 after millions of policies were canceled for not meeting new ACA standards. Obama also promised the law would reduce family premiums by an average of $2,500 annually, but premiums instead rose significantly. Claims that the ACA slowed health care inflation were contradicted by evidence of doubled premiums in many cases. Other broken promises included assertions that it wouldn't add to the deficit—in reality, it increased spending—and that it would not lead to rationing or reduced access, yet studies showed increased emergency room use and provider opt-outs. The administration downplayed the impact on existing plans, but the law's regulations forced changes that disrupted coverage for many. These misrepresentations were part of a strategy to build on the status quo while reassuring the insured, despite internal knowledge of potential disruptions.

Chief Justice Roberts' Strange Maneuver to Let It Stand

In the 2012 Supreme Court case NFIB v. Sebelius, Chief Justice John Roberts played a pivotal role in upholding the ACA through an unexpected shift. Initially, Roberts sided with the four conservative justices during internal deliberations to strike down the individual mandate as unconstitutional under the Commerce Clause, viewing it as regulating "inactivity" rather than commerce. However, in May 2012, he changed his vote, forming an alliance with the liberal justices to uphold the mandate by recharacterizing it as a tax under Congress's taxing power, rather than a penalty. This switch withstood a month-long effort by conservatives, led by Justice Kennedy, to bring him back, leading to speculation that the joint dissent was originally drafted as the majority opinion. Roberts also invalidated the Medicaid expansion as coercive on states, allowing them to opt out without losing existing funding, but preserved most of the law. His reasoning drew criticism for being incoherent and politically motivated, possibly to protect the Court's institutional standing amid partisan pressures, echoing historical chief justices like Charles Evans Hughes. This maneuver has been seen as a "strange turn," incorporating elements to limit federal overreach while saving the core of Obamacare.

Impact on Health Insurance Costs

The ACA has significantly affected health insurance premiums, generally driving them higher due to mandates, regulations, and subsidies that altered market dynamics. Nationally, average individual market premiums more than doubled, rising 129% from 2013 to 2019, with per-member per-month costs increasing from $232 to $515. In the non-group market, premiums increased 24.4% more in 2014 than they would have without the ACA, and insurer costs rose 11% higher. While some analyses suggest overall health care spending growth slowed post-ACA—from 6.9% annually (2000-2009) to 4.3% (2010-2018)—this is debated and not clearly attributable to the law, as premiums for many enrollees continued to climb faster than inflation. Expiring enhanced premium tax credits are exacerbating hikes, with 2026 premiums rising 26% on average, potentially more than doubling net payments for enrollees from $888 to $1,904 annually. In states using Healthcare.gov, benchmark silver premiums are up 30%, while state-run marketplaces see 17% increases. Factors like rising underlying health care prices, narrow networks, and risk pool shifts have contributed, with some relief in states using waivers to tailor plans, but overall, the law's structure has led to higher costs for unsubsidized individuals and families.