Affordable Care Act continues to get undue criticism

Reading letters to the editors in various newspapers on the Affordable Care Act (ACA), while a few concerns have merit, there is much undue criticism. The ACA is working pretty well in expanding coverage to uninsureds and is actually dampening costs per the Congressional Budget Office and PricewaterhouseCoopers. When its components are surveyed (guaranteed issue and renewability, preventive services, elimination of lifetime limits, capping profit margins baked into premiums), it actually polls favorably.

As noted before, the components poll better than the whole ACA, which in turn polls better when the name Obamacare is used. Yet, more people like the whole ACA than do not, which is a recent trend. However, even the recent polling is sloppy, as a solid 15% of people want the ACA to do more and be replaced by National Healthcare which is working well in other countries. So, these detractors are different from detractors who oppose it for political or free market reasons. While I would support elements of National Healthcare here in the US, that is not likely to happen, so the ACA is a good step forward down that path.

Regarding the subsidies, what many don’t realize is insured buyers were already subsidizing costs in hospital price increases to cover the uninsureds.  Absent a move to National Healthcare, this was a reasonable approach to gain access to many in need with affordable prices. The argument to do away with the subsidies to have a free market care system, would fail as many people could not afford coverage and we would be back in the same boat as before. What is also forgotten is the Chief Financial Officers of companies were asking for more consistent healthcare costs as rising costs were harming their profit/ loss statements. The ACA has actually helped accomplish a dampening of cost increases per the above two sources.

As a retired benefits professional and actuary, I am encouraged by the progress made by the ACA. Getting people access to coverage will help them get treatment in advance of worsening conditions. Its success is also in spite of twenty some odd states who have not expanded Medicaid. The states who did so are seeing better results in cost dampening and hospitals are more secure in funding. It would be nice to see the impact of ACA when fully implemented with all states expanding Medicaid.

I personally do not anticipate the Supreme Court to do away with the subsides in the national exchanges for the states who punted. I have always seen the court case to challenge the subsidies as narrow-minded and not looking at the context of what the law is trying to do. Also, running the national exchange for the states who asked was helpful to those states, so to now belittle those states and screw millions of people over, is cold-hearted. But, stranger things have happened. If it does happen, it is an easy fix, but hopefully it will not come to that given unnecessary politics.

What we don’t need is people who are against this law for political reasons to continue to find different ways to hammer it. Which is a shame as it is working pretty well and is ironic as it is based on a largely Republican idea. Let’s improve where needed, but do not do away with it.

9 thoughts on “Affordable Care Act continues to get undue criticism

    • Thanks. The Speaker was on George Stephanopolous’ show and evaded questions about its success and the failure of his predictions of it wrecking the economy. Senator Burr is advertising his replacement plan which is largely Obamacare without the subsidies.

    • Lisa, there is so much negativity because of the name of the author and then there are some legitimate concerns that should be addressed. One of things I don’t like is the former grasping at any straw to be critical of it. The best assessment is Obamacare is not perfect and overly complex, but it is working pretty well. You may take some comfort in Doctors for America, a group of 20,000 doctors and medical students is supportive of Obamacare. Thanks for your comments. BTG

  1. Note to Readers: The following is a Letter to the Editor in todays’ Charlotte Observer regarding an article about a conservative voter who did not sign up for the ACA, is going blind due to diabetes, and is blaming the ACA for not letting him enroll in Medicaid.. The truth is our state did not expand Medicaid, so people like him are left out in the cold. Here is the letter written by an attorney.

    ” Lang and others hurt by GOP efforts to misrepresent ACA

    As a lawyer I regularly meet people like Luis Lang who are devastated by unpaid medical expenses or unable to obtain care. They say they declined to buy insurance because they “are not fans of Obamacare.” Many believe the insurance is called “Obamacare,” literally. They’re surprised to learn it’s a mandate to purchase coverage from a regular insurance company.The irony is that their own cognitive dissonance fueled by the right’s continued mischaracterization of the law means a high number of GOP voters are suffering without coverage. When I meet them it’s already too late to help, as they have fallen below the subsidy threshold and are past the enrollment period, like Mr. Lang.

    Richard Peniston”

  2. I love that you point out that we’ve been subsidizing indigent care for a long time…and that’s such a horrible and ineffective way to deliver healthcare. I sure hope SCOTUS stands firm on this.

    • Thanks. That key point is lost on critics just as the point that CFOs said our state must change. I am optimistic on the SCOTUS ruling, but stranger things have happened.

  3. Note to Readers: The GOP has announced its official replacement plan and that same time Mitt Romney is saying his Massachusetts’ plan called Romenycare is not suitable for all of America. Readers may find of interest the benefits industry has not embraced the GOP plan, with a National Association of Underwriters noting it would disrupt the current system which is working pretty well.
    As noted above, the subsidies and mandate for coverage under the ACA are key to getting people covered – if we move back to a tax incented system, it won’t help those in need and middle class wage earners. It should be noted with employers dropping spouses from their plans without a work requirement, the reason was the existence of the ACA and its subsidies.

    On the Romney point, I get tickled when I see his comments on his huge success. The Tea Party leadership thought enough of Romneycare to strongly advocate it for the country via letters to President Bush, campaigning with Romney in 2008 and then on talk show circuit. So, Romney’s point is a large flip-flop from when he was running for President the first time. Could it be that the ACA is successful borrowing from his model?

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