Despite the best efforts of Republicans in Congress and the Trump administration, the Affordable Care Act continues to grow in popularity.
A Kaiser Health Tracking poll last month revealed that 53 percent of U.S. adults have a favorable view of the 2010 law — colloquially known as Obamacare — as opposed to 40 percent with a negative view. An August poll by Fox News showed more support for the law than for the Republican tax cuts passed earlier this year. And enrollment on Washington’s state marketplace — the enrollment period continues through Dec. 15 — is running at a faster pace than last year’s sign-ups.
The primary selling point for the law is that people with pre-existing conditions cannot be denied coverage. The neediest among us, Americans increasingly believe, should have access to health care just like everybody else. That belief played a role in the midterm election in which Democrats won control of the U.S. House of Representatives and four red states — Montana, Idaho, Nebraska and Utah — voted to expand access to Medicaid.
And still, last week, the administration moved to further undermine Obamacare. The White House will allow states to provide insurance that previously did not comply with the law; those plans often discriminate against people with pre-existing conditions or offer skimpy benefits. If a state seeks to include such plans, individuals who qualify for insurance subsidies may use that money to purchase a policy.
The danger for Obamacare is that healthy people will opt for paper-thin insurance plans. If a particular plan cannot keep healthy people in the fold, it will not be sustainable. As Vox.com explains, “At a certain point, premiums will increase so much for Obamacare-compliant coverage that states will have to put a cap on the federal assistance people receive so they meet the budget neutrality requirement.” Without financial incentives, insurers will exit the marketplace.
Since the Affordable Care Act was passed, Republicans have promised to repeal and replace the law. They had the final six years of President Obama’s presidency to come up with a plan, but when they took power in 2017 they failed to deliver. Rep. Jaime Herrera Beutler, R-Battle Ground, joined her colleagues in repeatedly voting to repeal Obamacare, and then joined them in failing to devise a replacement. Now, the Trump administration has spent two years destabilizing the law rather than improving it.
This year’s tax package included a repeal of an individual mandate penalty and contributed to premium hikes; the budget for creating awareness of the health care marketplace has been slashed; and multiple steps have been taken to allow junk plans that provide little coverage and destabilize the system. In addition, the administration has declined to defend the law in court, which is a basic function of the federal government.
Congress must act next year to stabilize Obamacare by rolling back the allowance of inadequate plans and restoring the marketing budget. In Washington, the Legislature would be wise to act on a request by Insurance Commissioner Mike Kreidler for a state reinsurance program that protects insurers when they face large claims.
Making health insurance more accessible and more affordable is in the best interest of the public and the national economy. If critics of Obamacare have a better way to do that, we are open to suggestions. But until then, Congress should strengthen the Affordable Care Act rather than allowing the administration to chip away at the law’s foundation.
