In the post-mortem analysis of Hillary Clinton’s presidential campaign, President Obama himself — or more specifically his namesake legacy, Obamacare — may have delivered one of the final blows.
A week before the election, the fourth open enrollment period of the Affordable Care Act began, and spikes in insurance premiums soared as high as 25 percent. Trump used it to his advantage, calling Obamacare a “catastrophe” and vowing to kill it “very, very quickly.”
If we take the president-elect at his word, the law will be “repealed and replaced” as soon as Obama leaves office.
Senate Majority Leader Mitch McConnell seconded that emotion on Wednesday. He told reporters that disposing of the ACA was “pretty high on our agenda, as you know.” And Speaker of the House Paul Ryan believes the federal government should play a minimal role in the business of health care. At a press conference Wednesday, Ryan exulted that Obama soon won’t be around to veto the dismantling of his insurance legacy.
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All this destructive talk is a shame, because Washington state is proof positive that Obamacare can work. Rates will increase here a modest 8 percent in 2017, and competition is relatively strong with 13 insurance companies remaining in the market.
“We’ll see premiums level off as insurers gain experience and more people get covered,” predicts state Insurance Commissioner Mike Kreidler. He received a vote of confidence last week with 60 percent support for his reelection bid.
Those who rejoice that the ACA is on course to collapse may want to ask the 1.6 million Washington residents who have accessed health care from Washington Healthplanfinder. Our state has been awarded millions of dollars in federal performance bonuses for exceeding the state-specific Medicaid enrollment target for children.
According to an Annie E. Casey Foundation report, Washington ranks fifth in the nation for child health. The Washington Apple Health Medicaid program covers more than half the state’s children, providing affordable options for families who used to have none.
Nationally, however, discontent with health care reform runs strong and doesn’t stop with the politicians. Exit polls from Tuesday’s election indicate that the Trump verdict was in large part a referendum on Obamacare.
In spite of the ACA’s strengths — including a 50-year drop in healthcare inflation, the clause that allows children to stay on their parents’ policy until age 26 and protections for people with pre-existing conditions — the government mandate never sat right with many Americans.
One of the biggest challenges has always been the philosophical linchpin that healthcare should be part of the American social contract, much like the military, schools, police and fire protection.
Indeed, in the richest nation in the world, access to health care and affordable insurance should not be a privilege afforded to the few. In spite of its flaws, and there are many, Obamacare has been a worthy public option plan wherein government sets the rules.
Its premise is less socialism and more symbiosis. Its success depends on mass participation to build a large risk pool, and it depends on young, healthy people climbing aboard.
Americans have accepted this “all-in”model with auto insurance. If good drivers suddenly pulled out, premiums would double in nanoseconds. This is why the ACA correctly made carrying health insurance a legal obligation. Consumers who opt out face tax penalties of $700 per person.
But instead of looking at states like Washington that are running their own Medicaid programs and working out the kinks by implementing cost-saving measures, congressional Republicans chose to dance the do-si-do of doomed legislation.
How many times did they try to fix the flaws in the ACA? Zero. How many times did they try to repeal it? Sixty.
No one knows exactly what a Trumped-up healthcare paradigm will look like. Other than an oft-cited health care savings account and tax credits, the president-elect and his fellow Republicans have been vague on the details.
When Obama met with Trump at the White House Thursday, he asked his successor to reconsider his strong stance against the ACA.
No promises were made, but Trump acknowledged afterward that Obamacare has favorable elements including extended coverage for dependents and the prohibition against insurers denying coverage.
We believe it would be a mistake for Trump to dismantle a health care network that took millions of dollars and eight years to build; its demise would no doubt leave both providers and patients bereft. Congressional Democrats should use every parliamentary tool at their disposal to save and fix it.
What will happen to the 20 million people who now have insurance under Obamacare? Uncertainties abound.
The only thing we know for sure is that what one president giveth — in tandem with a compliant Congress — another president can, and will, try to taketh away.