Let's face it. The Affordable Care Act, also known as Obamacare or the ACA is here to stay.
Let's face it. the Affordable Care Act, also known as Obamacare or the ACA is here to stay. In spite of all the political chest-pounding and rhetoric, it is abundantly clear that repealing and replacing Obamacare is harder than some thought.
For any serious "repeal and replace" effort to succeed, one has to have a bunch of different variables align. For One, Various interest groups and trade associations will have to have a seat at the discussion table. The Nation's Major Hospital operators like Quorum health and Lifepoint, as well as the likes of Aetna and United Health, will have to weigh in. Then, lawmakers and policy wonks will have to deal with the complicated issue of reducing the cost to patients while improving quality of care.
Folks seem to forget that the ACA was a culmination of years of actual work done by the progressive and liberal organizations, along with Republicans in an effort to bring some kind of Universal healthcare to Americans while maintaining a Conservative view of the structural integrity of a free market system and minimal government intervention in the system.
Various iterations of what would later become the ACA were polled, market tested and tried in smaller populations with some success.
The ACA ( With all it's issues) was the best outcome after months and years of work. No serious policymaker or politician would honestly think it would be "so easy" to repeal, let alone replace with something "better".
If the summer of 2017 taught us anything, it is that the only unpopular part about Obamacare is the "Obama" part. Folks actually like the level of care and affordability that the ACA provides.
On average, twice as many people each day have signed up for ACA coverage so far in 2017 compared to the previous 2 years. Despite claims that Obamacare is "Dead", "Exploding" and "Imploding"- all at the same time mind you. Turns out Americans Love the Affordable Care Act.
The ACA is not perfect, but.....
As both Republicans and Democrats have stated repeatedly over the last two years: "The Affordable Care Act is not perfect". Many of the ACA's issues are a result of an ever-evolving health insurance landscape and unrealistic expectations on the part of the Obama team.
Unrealistic expectations in terms of the percentage of "Young' people who would signup compared to older sicker Americans, and how much of a deterrent the tax penalty for not enrolling in a health plan would be. Some other structural issues with the law are also due to a continued effort by Republicans to repeal the Landmark law.
For examples, in 2014, congressional Republicans, led by Senator Marco Rubio, passed a bill to get rid of The ACA's "Risk Corridors" provision. This was a consequential part of the Law established to reimburse insurers for losses incurred as a result of guaranteeing insurance coverage for the older and sicker among us.
Funds from the Risk corridor pool would also serve as seed funding for newer insurance cooperatives like Consumers Choice of South Carolina. The Obama team felt that helping to prop up newer insurance players would ultimately help spur options in the marketplace, once these newer players became stable enough to function independently.
Politically-motivated actions by congressional Republicans would help create a business environment in which national insurance outfits like Aetna and United health saw it prudent to exit counties in which profit margins would inevitably be eroded, seeing as most of the insureds in these rural areas were older and sicker compared to more urban city centers. In other words, most insurers got outta dodge when they realized they would not be able to make any money in some counties, and Congress had taken away the money they were promised as reimbursement.
Obamacare is not Imploding and/or Exploding
Most Americans would be surprised to know that in spite of all the negative headlines and talking points we hear on TV regarding the state of the ACA, The Health exchanges are actually in pretty good shape. By that I mean, most of the Exchanges have stabilized over the last three years.
Consider these facts: About 20 million Americans have found coverage under the Obamacare since the law was rolled out in 2013, reducing the national uninsured rate to 8.6 % from 15.7% before the ACA, according to the CDC and Census data. (that is between the Marketplace’s 10.3 million, Medicaid expansion’s 11 million or so, about 2.6 million young adults staying on their parents' plan, the many newly covered via the employer mandate, and those covered under other coverage provisions created by the ACA).
Before the ACA, up to 47 million American Adults were uninsured. About 87 to 90% of folks insured under the ACA are getting some form of cost assistance, thus offsetting the effects of annual premium increases. Most Counties have at least one major Insurer, with specialized regional players like Blue Cross and Blue Shield and Anthem providing comprehensive plans in most areas.
So, What's Next?
Like most complex programs, the ACA is not without its issues. However, the law has gone a long way in reducing the number of uninsured Americans while providing low-income families with a real shot at getting the comprehensive healthcare one requires, regardless of health or socio-economic status.
It would be in the best interest of all, including future generations that we work to resolve some of the major challenges plaguing the Affordable Care Act and the Overall healthcare system in America and try to separate political mudslinging from the needs and wants of the many.