Weeks ago, President Donald Trump tweeted, “As I have always said, let ObamaCare fail and then come together and do a great healthcare plan. Stay tuned!”
And indeed, the system established by the Affordable Care Act is collapsing on its own. Average premiums are up 105 percent since the health overhaul law took effect, and premiums will soar again next year, based upon early announcements. That will drive more young and healthy people away, further destabilizing the health insurance markets.
People in 40 percent of U.S. counties risk having only one “choice” of plan next year, and some may have none as insurers flee the market because of heavy losses.
Under Obamacare, millions of people were driven out of health insurance policies they liked and could afford and were forced to buy expensive plans dictated by Washington. Now Obamacare is the only coverage available to them.
Republicans, who control both houses of Congress and the White House, must act so millions of people aren’t left without any health plan to choose from next year. They must provide a safety net for the next few years while building a new platform for better coverage going forward.
That is what bills in the House and Senate would do, although you’d never know it from reading headlines that warn “22 million people would lose coverage under Republican bills.”
Not true! Virtually all of these 22 million would voluntarily opt-out of health insurance once the Obamacare mandate that forces them to buy expensive policies or pay a fine is repealed.
The Congressional Budget Office says millions of people would simply drop coverage because the individual mandate penalties would be gone — including millions of people on Medicaid who pay nothing for their coverage. The CBO’s coverage estimates have been widely discredited.
And those Medicaid “cuts” that television ads say would leave disabled people without care? That wouldn’t happen either.
States would have hundreds of billions of dollars and new powers to modernize their Medicaid programs so they could provide better access to care. And in the process, the program could be saved for future generations.
Under Obamacare, Washington gave states a huge incentive to add able-bodied childless adults to Medicaid by paying almost all of the costs for these new enrollees.
But that means many states are leaving traditional Medicaid recipients, who have much greater medical needs and much lower incomes, on waiting lists. The Republican bills would rebalance the spending so Medicaid could focus on providing care for the most needy.
What about pre-existing conditions? They are covered. The current protections would stay in place unless states came up with a better plan — again, with new federal money — to provide assurances at least as good.
And what about insurance choices? States would regain powers to oversee their health insurance markets to give their citizens more choices of plans they could actually afford. The federal government has demonstrated it is inept in trying to direct health insurance markets as diverse as those in Montana, Manhattan and Miami.
Absent congressional action, the president could push Obamacare even closer to the edge with administrative actions such as further weakening enforcement of the individual mandate or backing off support during the open enrollment period this fall. But that is unlikely to happen.
Republicans know Obamacare is collapsing and have been working all year to try to pass a replace plan built on its crumbling platform.
They will continue that effort, possibly with bipartisan support once both parties realize the importance of rescuing people from this failing law. As Winston Churchill said, “You can always count on Americans to do the right thing — after they’ve tried everything else.”
Grace-Marie Turner, president of the Galen Institute, a nonprofit health policy think tank. Readers may write her at Galen, 128 S. Royal St., Alexandria, VA, 22314, or email her at firstname.lastname@example.org.