Obamacare is routinely described in the mainstream media as former President Barack Obama’s signature “achievement” during his two terms in the Oval Office, and there are certainly a host of memorable quotes from the debate in Congress on March 23rd 16 years ago, which resulted in the program’s enactment.

The most famous such quote likely came about when then-Speaker of the House Nancy Pelosi (D-Calif.) emerged from the smoke-filled room in the Capitol where final details were being negotiated by Democratic leaders and health care insurance industry lobbyists, then declared in a speech: “We have to pass the [health care] bill so that you can find out what is in it.”

And who can forget Obama’s promise, “If you like your current health care plan, you can keep it”? Other similar quotes were recently noted by Dr. Robert Moffit, the Heritage Foundation’s senior research fellow in Health and Welfare policy: “The bill would create robust and competitive health insurance markets; the bill would expand access to high quality health care; the bill would save the typical family $2500 in yearly health care costs; and the bill would bend the soaring health care cost curve downward.”

Sixteen years later, the American people have come to know all too well what was in the Obama legislation that became law as the “Affordable Care Act” (ACA) — including unprecedented bureaucratic complexity and thousands of unaccountably manufactured, devastatingly intrusive, and inefficient regulations whose cumulative impact has produced these devastating results:

Skyrocketing Premiums: As Moffit notes, “In the individual and small group markets, beneficiaries and taxpayers have been financing skyrocketing premiums. In 2014, when ACA insurance provisions went into effect, America’s health insurance markets were jolted by ‘sticker shock,’ and premium increases subsequently accelerated. In 2013, according to a Heritage Foundation analysis, an individual’s monthly premiums in the nation’s individual markets averaged $244, but by 2022, they had risen to $568 — a 133 percent increase. And for beneficiaries and taxpayers, the situation is worsening. For 2026, Kaiser Family Foundation analysts projected a breathtaking 18 percent average increase. Some affordability.”

Crazy Deductibles: Moffit continues, pointing to spiraling deductibles that can rapidly render health insurance all but unaffordable for middle- and lower middle-class Americans. “Between 2014 and 2024, ACA deductibles have jumped 40 percent. Over that same period, Heritage reports, the average ACA deductible for family coverage increased from $10,278 to $14,310,” he says.

Reduced Access to Doctors: Obama memorably promised us we could keep our doctors if we liked them, but once Obamacare became law, access to doctors and legions of medical specialists became harder and more expensive. “In 2014, according to the Heritage analysis, among the ACA’s standard “Silver plans,” “53 percent of them had ‘more restrictive’ provider networks, but such networks characterized 80 percent of such plans by 2024,” according to Moffit.

Before joining Heritage, Moffit served in senior positions during the Reagan administration managing congressional relations for the U.S. Office of Personnel Management (OPM) and the U.S. Department of Health and Human Services (HHS), both positions providing deep and advanced immersion and education in the intricacies of congressional legislative jockeying and the constant and compulsive centralization of power by anonymous, unaccountable bureaucrats.

Another Heritage expert on health care policies and programs is Edmund Haislmaier. In a 2024 analysis, Haislmaier reported on the results of his deep-dive into the data on Obamacare impacts and trends. He found, among much else, that Obama’s promises of more competition and wider selections for health care insurance plan customers actually produced less of both.

“Although Obamacare’s proponents claimed that the law’s new regulations, subsidies, and exchanges would increase insurer competition, the actual results have been the opposite. In 2013, the year before Obamacare took effect, there were 395 insurers offering coverage in the individual market at the state level. By 2018, there were only 181 insurers offering coverage on the Obamacare exchanges, and there were eight states in which only one insurer offered exchange coverage,” Haislmaier wrote.

He pointed out that officials during former President Joe Biden’s tenure in the Oval Office sought to stabilize the declining competition and choices offered by the Obamacare exchanges, and met with limited success, but the bottom line remained the same.

“For 2024, there are 304 insurers offering exchange coverage at the state level. That is an increase of 123 insurers over the low of 181 in 2018, but it still leaves the 2024 exchanges 23 percent less competitive than the individual market was before the implementation of Obamacare … despite increasing insurer participation over the past six years, only eight states have more insurers offering Obamacare exchange coverage in 2024 than they had before the ACA; eight others have the same number, and 34 states and the District of Columbia have fewer,” Haislmaier reported.

Considering the results of ACA’s passage 16 years ago, one wonders how different things might well have been had voters known what was in the bill before it was passed!