re: #104 ObserverArt

There’s so much misinformation and disinformation, underinformed people (even and especially critics) who think that they know best about how and why the ACA is in the predicament it is that when someone like President Clinton comes out with a statement, they’re going to defer to him, even if he isn’t right either.

The law isn’t perfect by any stretch, but here’s actual facts.

80% of Americans are unaffected by the ACA since they’re either already on Medicare/Medicaid or have employer-obtained health insurance. Those policies can and do change annually, but usually don’t - they’re not involved in the reshaping of the individual insurance marketplace.

Some businesses may claim that they’re dropping insurance over ACA requirements, but in many of those cases it’s about opposition to insurance policies for the employees including access to birth control, which the employer may claim to oppose.

No - the real changes are in the individual marketplace, where health exchanges are set up to provide affordable policies to those making up to 400% of the poverty line via subsidies. The states that set up their own exchanges are in a better position than the federal exchange, which was saddled with the burden of providing access to more states than originally envisioned and GOP delays in deciding to opt out of the state-run exchanges. Those are issues that can be overcome, but it takes time. The delays do run up against two separate hard deadlines - a mid-December deadline to get policies that are effective January 1, and a March deadline that avoids IRS imposition of the individual mandate penalties for the year (have a policy effective by the later of the two dates, and you’re not subject to the penalty).

So why are there issues? Some insurers have decided not to provide policies in some states, limiting choices, and allowing those remaining insurers to charge higher premiums since there’s a lack of competition. States like Wisconsin allowed this situation (even encouraging it), while similar neighboring states like Minnesota are seeing much lower premiums where more competition and a state-run exchange are in place.

Allowing sub-par insurance policies to be reinstituted does not help the situation. Policies that aren’t worth the paper they’re written on may on paper avoid the individual mandate penalties and let some people pay less than they would on the exchanges, but that also means that the marketplace for insurance will not have the mix of people needed to sustain the changes (the subsidies, the increased number of insureds, etc.). If anything, this particular bit of policy would do more to break the ACA than many of the other defund/delay/destroy ACA attempts by the GOP.

The health care insurance marketplace is broken - that’s even before the ACA. The ACA is an attempt to reshape it, and the reshaping is not without some costs - higher premiums to some people, which allows an even greater number of people to get health insurance. Spreading out the costs will then serve to lower the premiums over time (and in states where the premiums were overcharged by insurers, rebates will be forthcoming - insurers that spend less than 80% on their insurance costs must rebate the difference to the insureds).

Even those cost savings get slammed by the GOP. Speaker Boehner was busy complaining that the changes are causing jobs lost, even as it improves efficiencies and lowers the cost that the feds would have to pay for subsidies over the long run (since the subsidies go to the insurers to cover the costs the insureds pay).