Liberal flip-flop: To keep or dump ObamaCare?
Many media outlets and political leaders continue to promote the belief that more than 20 million people will lose health insurance if the Affordable Care Act is struck down. That’s most likely false. At the very least, the loss would not be immediate, as the case would likely be sent back to the district court to establish a reasonable timeframe for the law to come to an end.
In the meantime, the exchanges would still be in place, American’s private and employer-provided insurance wouldn’t change, and Congress will have ample time and renewed motivation to look at various plans designed to protect vulnerable communities and promote affordability.
The lawsuit puts Democrats in a tough spot. On the one hand, they have to criticize any effort to dismantle the ACA. Sen. Chuck Schumer (D-N.Y.) and Speaker Nancy Pelosi (D-Calif.) even go so far as to place blame on President Donald Trump for the lawsuit, though he is technically the defendant. On the other hand, every Democratic presidential candidate acknowledges the law is deeply flawed and have all proposed plans that address its failures. So, which is it, keep it or dump it?
Unfortunately, their plans to fix the ACA only propose more of the same thing that caused the failure in the first place: a narrow focus on increasing insurance coverage instead of improving care (even for those with pre-existing conditions). The system is so broken, millions of people are even refusing no-cost health insurance.
Just like in the exchange, the states that have expanded Medicaid are facing a similar problem. Putting millions more people on government-provided insurance has blown holes in state budgets. New York, for example, faces a $6.1 billion budget deficit next year with two-thirds of it linked to Medicaid. The state’s response to this budgetary crisis was clear; payments would be slashed for several provider types. A report on this matter claimed, “savings may include across the board reductions in rates paid to providers and health plans.”
Continued reductions in payments, coupled with the administrative burden, will result in fewer medical professionals and facilities participating in the Medicaid program. And that will hurt patients.
In seeking to simply expand coverage, the ACA made health care extraordinarily expensive. The law became a boon to special interest insurance corporations and created powerful middlemen that contribute to the high prices. Many Americans remain uninsured because out-of-pocket costs are too high and the value too low even when they are qualified or eligible to participate in programs that subsidize their premiums.
The law must be scrapped. The Court has the opportunity to do that and force Congress to act where it has previously failed.
Reform should focus on empowering the individuals and families, doctors and patients — not the insurers or the government. No company or bureaucrat should be able to overrule a doctor’s recommendation.
This is not a binary choice of socialized healthcare or the way it used to be. We have a chance to make something of health care delivery that allows it to be about the people receiving the care, as well as those delivering it.
Regardless of the outcome from the Supreme Court, Congress must act to unleash one of the most regulated industries in our nation. Americans don’t care about the intricacies of health insurance policy; they just want health care for themselves and their families. We have the chance to do better and we just may — if we focus on patients rather than politics.
David Balat is the Director of the Right on Healthcare initiative with Texas Public Policy Foundation. Follow him on Twitter @DavidBalatHC.