We all know what I’m talking about, what Republicans in Congress and in the Trump administration say to justify the repeal and replace of the Affordable Care Act, or Obamacare. They say that premiums are skyrocketing, that there are people who have one or no options in their health insurance markets, and that the quality of care is abysmal when people actually can get it. But that’s rhetoric, and it can be greatly misleading. So, what is actually happening with Obamacare? Is it imploding, like Republicans say, is it thriving as Democrats will tell you? Let’s find out.
Despite Republican’s doomsday rhetoric, the ACA is not “collapsing” as Speaker Paul Ryan put it. In fact, for the first time this year, the insurers selling Obamacare plans are seeing a path towards profitability. If you turn on Hannity on any given night after a Republican health care vote, someone will surely be talking about rising premiums and insurers leaving markets. Contrary to that viewpoint, only about 25,000 of Obamacare customers live in places facing the risk of having no insurer next year. That is out of the more than 11 million people that receive Obamacare coverage. That means that only 0.0025% of Obamacare recipients are at risk of having no coverage in the coming year. I’m not saying that 25,000 people being at risk for not receiving Obamacare customers in the next year are O.K., but it’s not by any stretch of the words indicative of a ‘collapse’ or an ‘implosion’.
[The Affordable Care Act] has largely succeeded not failed; it is impossible for the state goals of repeal to be achieved, [The political fallout] would be devestating, [opponents of Obamacare] are in for a dose of humiliation as they realize belatedly that the promises they have been making for six years are empty,”
-Henry Aaron, Senior Fellow, The Brookings Institution
Legislation that seeks to fundamentally change an industry that takes up a $3 trillion chunk of the U.S. economy is certain to end up running into potholes. Once you insert an entitlement into the economy, the budget, and the American people begin to count on it, it is hard to remove it completely and then change it around so that it abides by conservative beliefs that people should not be helped out by the government or other people by way of tax dollars. It has been seven years now since the ACA was signed into law, it has had nearly a decade to cement itself into the economy and the social structure of the United States.
I would have expected more insurance companies to be exiting. It has been remarkable how resilient the market has been
-Cynthia Cox, Kaiser Foundation associate director of health reform and private insurance
While premiums have increased in the exchanges, Obamacare’s tax credits adjust for cost of living, thereby the vast majority of Obamacare recipients would be able to access carw for less than $100 a month. “Under current law, most subsidized enrollees purchasing health insurance coverage in the non-group market are largely insulated from increases in premiums because of their out-of-pocket payments for premiums are based on a percentage of their income; the governkent pays the difference,” the non-partisan Congressional Budget Office (CBO) said.
The Trump administration has poured gasoline on the fires of uncertainty in the private insurance market, What plans need more than anything else is some predictability and some certainty
-Senator Ron Wyden (D-Oregon), Ranking Democrat, Senate Finance Committee
A political problem that Republicans will probably face is that many of the states where the most people have been insured under Obamacare are states where Republicans are elected. These are states that Trump won in 2016, including Kentucky, West Virginia, and Arkansas. Under the ACA, the number of people uninsured dropped the most in these states, which could lead to some political fallout for Republicans in 2018. The ACA has also been gaining popularity, as of April 2017, 55% of Americans approve of the ACA. This has been a common paradox in politics. Democrats advocate for entitlements that benefit people in Republican states, and Republicans oppose them.
We’re not seeing any evidence of a death spiral or a market collapse. Rather, what it looks like is insurers are on track to have their best year since the [Affordable Car Act] began
But not everything is perfect under Obamacare. Democrats in Congress have acknowledged that there are problems with the 2010 law and that they need to be fixed. Unfortunately, Republicans and Democrats alike have refused to work in a bipartisan fashion in order to fix Obamacare, not repeal and replace it. At a press conference on July 28, House Minority Leader Nancy Pelosi said that “We call upon the speaker to establish a process – we can go right to the committees – and have the discussion on how we keep America healthy,” Her goal is to establish a process and a dialogue to improve Obamacare with the help, not resistance, of Republicans. Although this is unlikely to happen, as the goals of the two parties are too different for them to be able to come to a consensus at this time. The majority of Americans agree with Pelosi that both parties need to work together on health care reform. In a CNN/ORC poll, 77% of those surveyed said that Republicans in Congress should work with Democrats. Only 12% said that they should pass health care legislation with only GOP support.
At least, for now, the Republican effort to repeal and replace Obamacare looks like it is dead, but we’ll see what happens next. It seems like tax reform is the next issue the President wants to tackle, and reports say that he is far more enthusiastic about it. Don’t forget to subscribe to our morning newsletter, the Morning Guide to Politics.