Hillarycare Tried to Put Everyone in an HMO, Obamacare Is Succeeding

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Those of us who fought co-Presidents Bill and Hillary Clinton’s 1993-4 attempt to put every American in an HMO thought we had won that battle. We were wrong. President Obama is achieving their goal with Obamacare. 

A health maintenance organization, or HMO, is a managed care health plan that saves money by restricting access to health care—though HMO defenders would say it’s because they provide better, more efficient care.  

In most cases patients must remain in the HMO’s network of health care providers—which, under Obamacare is small and getting smaller—and must go through a “gatekeeper” to see a specialist. 

During the Hillarycare battle, HMOs were seen as imposing a kind of private sector rationing of health care, which helps explain why most people opted for preferred provider organizations, or PPOs, because they are more flexible when it comes to choosing a health care provider. 

But the PPO option is quickly passing away in the era of Obamacare health insurance exchanges. As Kaiser Health News explains, PPO freedom of choice is driving up premium costs faster than HMOs, and so insurers are canceling those plans. 

The Kaiser article cites one of Katherine Hempstead’s studies for the Robert Wood Johnson Foundation looking at the availability of PPOs. “Hempstead found that there will be fewer or no silver-level PPOs in 22 states next year. Federal records show there will be none in Miami and most Florida counties, much of Texas, New Mexico, New York and many counties in Mississippi and South Carolina.” 

To take one example, Texas BlueCross has canceled its statewide Obamacare-qualified PPO, which covered 367,000 Texans, because the insurer lost $400,000 million on that group in one year. It is being replaced with an HMO. 

Americans rejected Hillarycare when the Clintons were in the White House, and voters punished Democrats at the polls in 1994 for trying. Obama succeeded where the Clintons failed and voters punished Democrats in the 2010 and 2014 elections. And it’s likely that another round of punishment is coming in the fall of 2016—right after even more voters learn they will be forced into an HMO.

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