We’ve been held hostage by Congress this summer, waiting to see what might happen to our coverage and our neighbors’. But at the moment we’re back where we started, with the Affordable Care Act, also known as ObamaCare.
The Congressional Budget Office estimates 24 million people could lose health insurance without the ACA. Yet President Trump says openly he wants it to “implode.” What kind of regard does that show for the real people whose health—sometimes even lives—are at stake?
We all know the law needs fixing. Major social programs like Medicare and Social Security were implemented, then revised when the problems inevitably showed themselves. Instead of revising it, Congress spent seven years complaining and promising to repeal the ACA without producing a workable replacement.
The sad thing is, we’ve known how to fix it almost since it was launched.
Most of the problems lie with the Marketplace exchanges, which cover ten million Americans who aren’t on Medicare or Medicaid or insured by their employers or the government. Here’s how the government can fix it:
— Offer insurance companies greater incentives to participate.
The more companies that offer coverage in one place, the lower the premiums. But right now one-third of those on the exchanges have only one “choice” of insurers.
— Offer more generous subsidies for those who purchase insurance on the exchanges, and include more people by raising the income eligibility level.
With these two changes, everyone who needs it could afford policies on the Marketplace.
— Add a public option.
By offering its own plans, the government could increase competition and lower prices. It’s done that for decades with Medicare and Medicaid.
Yes, these changes would be expensive. But so is the alternative: millions of Americans uninsured, rural hospitals closing, emergency rooms overburdened—in short, a healthcare system in chaos. The U.S.’s annual budget exceeds $1 trillion: it’s not more money we need, but more political will.
In 2003 a Republican Congress under President George W. Bush made these very changes to shore up the shaky Medicare Advantage program, the expanded Medicare so popular with seniors. It worked. Insurers signed on, and a volatile healthcare market stabilized.
The government also must hit those who don’t enroll with a real penalty—and enforce it. Now it’s much cheaper for young, healthy people to opt out and pay fines that are essentially voluntary anyway. Life is unpredictable: these folk may need coverage when they least expect it. But they also need to do it for the community. Without a large, diverse pool, everyone loses.
Medicaid also must be expanded in every state, which was part of the plan all along. Instead, eighteen states with Republican governors, including ours, refused the expansion, and now they have the gravest healthcare problems.
Medicaid has always been how we provided health care for our poorest citizens. It’s a human issue, but it’s economic, too. According to David Richards of the NC Department of Health and Human Services, 625,000 North Carolinians are in health insurance limbo, earning too much money for Medicaid and too little for the Exchanges. Likely they can’t afford preventative care, and often they show up in ER’s, which are forced to treat them but may not be reimbursed, inflating healthcare costs for everyone.
It’s time for Congress to stop playing politics with our health care. Both parties need to work across the aisle to preserve the strengths of ObamaCare and to solve its problems.
The article was written by members of the Scotland County Democratic Women. They are Jan Schmidt, Nancy Barrineau, Bonnie Kelley and Mary Evans.