Sunday, April 20, 2014
The American health care “system” is an outrage.
A man looks over the ACA signup page on the healthcare.gov website in this Oct. 2 photo illustration. Controversy over the fumbling of the website’s rollout shouldn’t be allowed to derail much-needed health care reform.
Forty-eight million people have no health insurance at all. When they get sick or in an accident, they have to pay out-of-pocket for the most expensive care in the world, risking bankruptcy every time they get out of bed.
Nineteen million Americans buy health insurance on the individual market with no subsidy from an employer. Their coverage has become so expensive, millions opt for high-deductible, low-coverage plans in the hope that their policies will give them enough coverage to avoid a financial catastrophe. For years, employers have been scaling back the plans they offer in order to reduce their exposure to escalating premiums, shifting costs onto employees.
Thirty-seven percent of American adults, both those with and without insurance, went without recommended care between February and June of this year because of the cost of visiting a doctor or filling a prescription, according to a study by The Commonwealth Fund. The same study found that 40 percent of Americans spent $1,000 or more for health care over and above their insurance premiums.
But what’s the reason for the outrage that dominates the news lately? A balky website? A broken presidential promise?
There actually are serious problems with the Affordable Care Act, but they are not the ones we have been hearing about. They are political problems that put the future of the law at risk.
The Obama administration badly fumbled the rollout of the new electronic marketplace, handing the people who have tried to repeal this package of reforms the publicity wedge they were looking for. The president was made to eat a promise he never should have made after insurance companies informed customers that they had to stop offering plans that didn’t comply with the law, infuriating people who had been told they could keep plans that they liked. If these political storms continue to rage, the health care law could be gutted before it is fully launched, putting off comprehensive health care reform for another generation.
That is probably not going to happen, though. People eligible for insurance through the exchanges still have a month to sign up for coverage that would be effective Jan. 1, and they have more than five months to sign up for individual coverage without risking a tax penalty.
There is evidence that the online insurance exchange website is finally starting to work. An embarrassing six weeks after it was set up, thousands of people are signing up for plans, and their numbers will likely increase as the deadlines draw closer. President Obama has offered to let individuals keep a current plan that does not meet the minimum standards of the Affordable Care Act if they want to for another year (and if their insurance company agrees to sell it to them).
When those customers compare their old insurance plans to the ones available in the health care exchanges, they may like what they see. The new plans come with subsidies to consumers with incomes up to 400 percent of the federal poverty line ($45,960 for an individual and $94,200 for a family of four). They may find that the new plans cover more and end up costing less.
That won’t be true for everyone. Some people will pay more for coverage, and others will still not be able to afford insurance, especially in states like Maine that have not expanded their Medicaid programs. But thanks to the Affordable Care Act, tens of millions of Americans will have health insurance they can afford, many for the first time in their lives.
The website fiasco shows that there is still a lot of work to do, but it is not the greatest outrage – that is that there are still politicians and corporations who want to deny health insurance to millions of people, and offer no alternative but the current “system.”
Lawmakers of both parties should do better than that. They should be working to make this law better, not rooting for it to fail.