Street Corner Soapbox
The qualms and benefits of the Affordable Care Act and the glitchy HealthCare.gov.
Whenever we posted anything on the Erie Reader Facebook page or Twitter feed about the Affordable Care Act (ACA), we got a lot of negative feedback from a few folks. Apparently there are people out there who really, really hate Obamacare.
Here's the thing. Even with all its faults – policy cancellations, increased costs for some, the hilariously inept launching of Healthcare.gov, the online portal for the ACA's health exchange – even with all these warts and hiccups, it's still better than the status quo.
And this coming from a guy who is ambivalent about the ACA.
Let's start with the complaints. The most recent – and loudest, to date – is that insurance companies are canceling some policies. Conservative opponents are making a lot out of this – President Barack Obama, after all, once famously promised that you'd be able to keep your insurance if you wanted to under his plan – and, like all things with the Obama-obsessed, you can almost hear the shrill screaming even in their Facebook comments.
People! are! losing! their! health! care! insurance!
First, those that are losing their insurance plans are primarily individual policyholders who bought really crappy policies that were created by insurance companies after the ACA was passed into law. Those policies don't meet the basic standards set out in the ACA to protect consumers from...well...really crappy health care plans.
What are those standards? For one, insurance companies can no longer cap the amount of benefits they pay out to policyholders. So, if a catastrophic event happens in your life, you are not kicked to the curb in your greatest hour of need. For another, preventative care is now free. That saves us all money, because it causes people to use the kind of health care that prevents illness or catches it in its early stages, when it's cheaper to treat.
So, yes. People are losing their health insurance plans. And, yes, the insurance mandate forces them to purchase new policies. Which will be better.
That brings us to the next complaint. Insurance! rates! will! go! up!
There is no doubt that, for some, insurance rates will go up. But, just like all the other conservative hyperbole surrounding all things Obama, that fact has been exaggerated.
Eric Stern, for example, a former policy adviser to Montana Gov. Brian Schweitzer, fact-checked a Fox News Sean Hannity segment that featured three couples who were complaining about dropped coverage and increased premiums under the ACA. Stern found that all three couples would find better insurance plans in the exchange, with lower deductibles and monthly rates than what they had previously.
Michael Hiltzik of the Los Angeles Times debunked a similar claim made by enraged opponent of Obamacare, Deborah Cavallaro, who went on CNBC to complain about her canceled plan, and the cost of a new plan she'd be required to purchase. Cavallaro's old plan cost $293 a month – but came with a $5,000 deductible, limited her to two doctor visits a year, and featured a cap on out-of-pocket spending of $8,500. Hiltzik found a "silver" plan in the health insurance exchange that cost $40 a month more, but had a $2,000 deductible, unlimited doctor visits, and a $6,350 cap on out-of-pocket. There was also a lower-priced plan – and at $256 a month, lower than her previous insurance – that had a $5,000 deductible, unlimited doctor visits, and a $6,350 cap on out-of-pocket expenses.
That is, Cavallaro's options in the exchange are all better than her current plan.
Consider, that while the ACA is causing some health care premiums to go up, it's also providing tax credits to offset the cost of those premiums. In Pennsylvania alone, the Kaiser Family Foundation estimates, more than 715,000 of nearly 1.2 million individual policyholders in the state will qualify for those tax credits. Many whose premiums are going up under the new regulations will find themselves paying less for health insurance.
The ACA also allows individuals age 26 and under to remain on their parents' insurance plans. So for many finishing school and first entering the workplace, individual insurance policies won't be an undue financial burden.
Still, it's hard to look away from the law's flaws. There are few cost controls in it, for one. Providing universal health care should help with the spiraling cost of health care: it should curb the practice of the under- and uninsured from using the Emergency Room as their primary health care, for one. Still, for-profit medical centers continue to encourage expensive procedures, pharmaceutical companies still encourage doctors to use expensive prescription medication instead of cheap generics, and the mess of health care accounting with its byzantine pricing structures makes U.S. administrative costs the highest in the world.
And don't even get me started about Healthcare.gov.
It's probably important to remember that this is a conservative plan, first conceived in the Republican Nixon adminstration in the mid-'70s and making appearances periodically among Republicans ever since. The individual mandate, for example, was thought up by the conservative think tank, the Heritage Foundation, and the ACA itself is modeled on the Massachusetts health reform crafted and implemented by then-governor and later 2012 Republican presidential candidate, Mitt Romney.
No wonder it's a disaster.
Really, the easiest solution would have single-payer health care, similar to what Canadians enjoy. Medicare for all, say. The system is there, it works well, it's efficient and cheap, and those on Medicare love it.
Maybe if the ACA really falls flat, we'll still have a chance at real reform.
Jay Stevens can be contacted at Jay@ErieReader.com, and you can follow him on Twitter @Snevets_Yaj.