Since 2010 one goal above all others has united the Republican Party. That goal is the repeal of the Affordable Care Act aka Obamacare. Republicans say Obamacare is in a “death spiral” about to completely die if nothing is done to save it.They claim it’s a job killer, creating huge deficits in the national budget and makes insurance un-affordable for everyone. What they don’t say is their ultimate goal is to stop government subsidies to people who can’t afford health insurance.
The lies Republicans spread about Obamacare are meant to make people forget about the truths that make this law a must for America. They don’t want us to remember how things were before Obamacare, back in the days of the reviled HMO’s.
No more HMO’S
These were the days when healthcare was truly controlled, not the false government control Republicans lie about. This was control by corporations who cared only about their profit and not our health. Doctors had to call insurance companies to ask for permission to give us treatment. Pharmacist would call to get guidance on whether to fill our prescriptions with the brand name or generic drug.
Fortunately Obamacare gave control of our healthcare back to our Doctor’s. Republicans not only want us to forget the HMO days but forget four current things about Obamacare.
1) The rate of rising healthcare cost for most people has slowed considerably. In 2014 there was a 3% increase, 2015 a 4% increase and 2016 a 3% increase. The 25% or Arizona’s 100% premium increases with the high deductibles affect the 10 million plus people buying insurance through Obamacare exchanges.
85% of these people are not affected by the increases because they receive federal subsidies. So we are left with approximately 2-3 million people out of 100 million plus who are negatively impacted by increases. They deserve repair to Obamacare and not repeal and abandonment.
Rebates to customers
Prior to Obamacare annual double digit premium increases hit everyone. Now some have had their premiums rebated. Obamacare requires insurance companies to rebate consumers if the amount they spend on health benefits and quality of care is too low. They must spend 80% of the premium collected on healthcare and not administrative cost.
Since this requirement was put in place in 2011 through 2014, more than $2.4 billion in total refunds will have been paid to consumers.
Access to healthcare insurance means no true coverage
2) Obamacare makes insurance companies cover a minimum of 60% of actual healthcare cost. This requirement goes away with repeal of the law. Premiums and deductibles for a plan similar to your current one will increase.
Republicans try to hide this fact by saying that people will have increased access to health insurance. What they really mean is insurance companies will be able to offer many cheap plans that provide no substantial healthcare.
Plans providing real healthcare will be available but not affordable because federal subsidies used to pay for them are eliminated. They are replaced with tax credits.
Tax credits don’t help people who can’t afford insurance
Tax credits only help people who have their own money to buy the plan they can already afford. The credits will give tax refunds with money currently used to help people who can’t afford insurance, to buy it.
With no requirement that insurance cover 60% of healthcare cost companies can design and sell any plan they want. This means that if you are in the private market or in an employee sponsored plan, both your premiums and deductibles for your current plan will increase.
3) Obamacare is not a job-killer it has help create jobs. Obamacare has led to 20 million people gaining health insurance and that’s created a great demand for healthcare workers to provide it. Hospitals have hired more people in the past 18 months — nearly 270,000 new employees — than in the previous six years before that combined.
Healthcare industry creates more jobs than most
Private sector job growth has occurred every single month since Obamacare passed in March 2010. The healthcare sector created 234,600 jobs in the first half of 2016, including 39,000 new jobs in June, according to Bureau of Labor Statistics. The 2016 growth is outpacing the 225,300 healthcare jobs created in the first six months of 2015, a year that finished with a record 471,600 new jobs in the healthcare sector, according to BLS data. Nearly one in four jobs created so far in 2016 is in the healthcare sector.
The Republican claim that Obamacare kills jobs is not backed-up by the facts. Employers cutting back on their work force or changing full-time positions to part-time positions to avoid Obamacare regulations is not occurring.
All of the job gains that have occurred since March 2010 have been in full-time employment. The number of workers who hold jobs that are usually part-time has actually declined modestly.
Millennials need to do their part and sign up
4) The main reason premiums and deductibles are rising is because young people (millennials) are not signing up.
Only 28% of exchange members in 2014 were in the coveted 18-34 age range, and that percentage stayed level for 2016. It’s below the 40% level many actuaries say is needed to create a more stable rate environment.
The insurance industry has a name for that condition, which Obamacare was designed to fight. It’s called adverse selection. Adverse selection undermines the individual insurance market because Obamacare allows anyone to buy coverage on the exchanges even if they have pre-existing medical conditions.
The sickest people with untreated chronic health conditions use a lot of healthcare. They generally chose plans with higher monthly premiums to gain access to broader provider networks and more generous coverage.
The few younger and healthier people who buy plans choose ones with lower premiums. They don’t visit the doctor often and are willing to accept the risk of paying high deductibles for occasional visits. They are also willing to put up with narrower networks.
Republicans need to accept individual mandate
But there has to be the right mix of those two groups to keep premiums affordable. In other words there must be more healthy people buying insurance than there are sick people using insurance. This mix is found in employer based plans which is why their premiums and deductibles rose only 3% in 2016.
Republicans can’t embrace the fact that Obamacare can’t work without the individual mandate that everyone must buy health insurance. To them this is government over-reach because they don’t think healthcare is a right that our government should provide.
They would do well to face the fact that the toothpaste is out of the tube, and there is no putting it back in. Repealing Obamacare is the surest path to ending their majorities in both houses of Congress. If President Trump intends to be a two term President, he will lead Republicans to REPAIR Obamacare not repeal it.