Note to Democrat Senators running for President – stabilize the ACA

The following note was posted on the website for the seven Democrat Senators running for President, with a copy to select others.


I am an Independent voter and retired, but my career included being an actuary, benefits consultant and benefits manager for a Fortune 500 company. I have shared with Senators and Congress people a few thoughts on stabilizing the ACA, something Democrats campaigned on last fall and won.

Medicare for All deserves debate, but will require a more elongated and data-driven discussion. We need to have Congress take steps to stabilize the ACA now. To do otherwise, is a disservice to Americans.

Here are my thoughts.

– the GOP sabotaged the ACA in two specific steps which increased premiums even more. They defunded 89% of the risk corridors (for initial adverse selection) driving some insurers out of the market. The other is Trump reneged on reimbursing insurers for copays/ deductibles for people making less than 2 1/2 times the poverty level. My suggestion is to pay insurers what we promised in writing and invite those who left back into the exchanges.*

– I suggest the lowering of the eligibility age for Medicare to age 62 (the age when retirees can first draw Social Security). This could be viewed as a pilot for Medicare for All. This action would lower the Medicare premium rate for all and lower the ACA exchange premiums due to the age of those leaving the ACA and joining Medicare. In other words, both the average age of Medicare and the exchanges would be lower, so the actuarial cost per person is less in both.

– Actively encourage the expansion of Medicaid in the remaining states – this will help the economies, healthcare providers and people in those markets. There are now 36 states who have done so. GOP Ohio Governor John Kasich calls Medicaid expansion a “no brainer.”

– Finally, where only one option exists in a rural county, offer a Medicare option, again as a pilot. People should have choices.

There are other changes that would help, but this needs a data-driven analysis and not whatever the GOP did in 2017, which was a horrible approach to legislation that resulted in horrible legislation. Had any of the GOP legislation passed to kill the ACA, the GOP would have lost even more seats and we would be talking about a recession coming our way.


* Please feel free to Google these topics: “Marco Rubio and risk corridors” and Donald “Trump and ACA subsidy decision”. The former caused insurance premiums to increase more than they otherwise would have and some insurance companies left the exchanges with the US government owing them money.  The risk corridors were designed to tie insurers over until the initial adverse selection flushed out of the system.

The latter was frustrating because the subsidy helped people in need. Trump untruthfully claimed it will only affect insurer profits, but the carriers committed to the customers to do this under contract. The CBO said this action raised the deficit by $10 billion, since premium subsidies went up to pay for the increased premiums. In my home state of NC, BCBS said before the Trump decision premiums were NOT going to increase. After the decision, the premiums increased 8%.

Saying this in a more succinct way, the GOP screwed American people to win a political argument. Sadly, that is the truth, but very few people know of this. This also is an exemplar of the President’s lying affecting hard-working people. Lying is one thing, but setting policy off lying is another matter altogether.

Note, the ACA is imperfect and complex. But, it still has not been fully implemented in all the states with those who did not expand Medicaid. But, people need to be fully aware of the sabotaging of the ACA undertaken by the GOP, which I find interesting, as the ACA is largely based on a GOP idea. That is politics for you – you did it, so I must be against it.

14 thoughts on “Note to Democrat Senators running for President – stabilize the ACA

    • Thanks Jill. I sound like a broken record. My fear is the Medicare for All movement will stand in the way of needed change now. If the Dems wait, we are talking 2021 for the debate to begin and that would be a dereliction of duty. Keith

      • Nah, you don’t sound like a broken record. Sometimes it seems we have to keep repeating the same message over and over until people finally get it. I do the same, and I’m thinking we might need to actually beat them over the head with the message! Health care and the environment are two things that, as you say, simply cannot wait until we get rid of Trump to be addressed. The key is to find a way to make the Senate find their conscience. With both the House and Senate on board, Trump could become fairly powerless and we could move on with sensible laws once again!

      • Jill, you are right. On healthcare, the GOP has cornered itself by adamantly fighting the ACA. The Dems are discussing options. The same holds true on climate change. I’d rather discuss options like the Green New Deal than ignore the greatest risks facing the planet.

        As a former Republican, the GOP needs to be called on rhe carpet for their dearth of ideas and subterfuge to avoid problems altogether. They would rather support Trump’s fantasies than solve real problems. Keith

      • Do you think the GOP can survive Trump? It seems that they have thrown their entire lot in with his, and when he goes down, I wonder what happens to the party? Either they are going to have to make some mega-changes, I think, or be replaced by a more moderate-leaning party. Either way, I think a change is coming.

      • I got this of Quora..

        An engineer would say that the Republican Party is stuck in a feedback loop. I’m probably going to offend some readers with what I’m about to say, but there’s no sugar coating here.
        This is a party whose representatives are, to a great extent, bought and paid for. That’s not new, and it’s not unique to Republicans. They do seem far worse, though.

        In a situation worsened when the GOP pulled down or weakened caps on campaign contributions, they receive huge donations (heh – right, “donations”) from massively well-funded lobbying groups. The only problem is, massively well-funded lobbying groups want something in exchange but can’t vote. Pesky democracy.

        So, to give those groups what they want for their money, the Republican politicians have to find voters who can be manipulated into voting for favors, loopholes, and lower taxes for people far richer than themselves without noticing that they’re doing it. And they will use any means necessary to do that. Power being an end unto itself. They work for the people who fund their campaigns.

        They thump the Bible, they exploit fears of anyone not like them, they tell people there will be “death panels” roving the land if you vote for subsidized healthcare, and just generally do or say anything that can coerce or frighten people into voting for them. And when the corruption finds the spotlight, they launch endless Congressional “investigations” just to ensure that the people believe that the other side is “just as bad”. Seriously, if I had a nickel for every time I heard that phrase.

        Along came cable news and a guy named Rupert Murdoch. He discovered that if you create an entertainment network and put “News” in the name, but only say things which validate and reinforce the idea that the conservative side is always right, you get HUGE ratings. Good fact is always more validating than real fact. Then, along came the internet which, much like Rush Limbaugh’s AM radio empire of nonsense before it, discovered much the same thing and could go even further off the deep end. All of this created a feedback loop in the minds of these voters to the point that many of them now exist in an alternate reality.

        At some point though, the GOP lost control of their little dog and pony show and the inmates began running the asylum. All of that crazy stuff that the Republican politicians, and their now massive “conservative” (it’s not, really) media blob, and the Russians who joined in on a good thing out of a fear of a Clinton administration, had been feeding their voters for so long came back to bite them. The monster they created isn’t just voting for their agenda anymore. It’s electing itself and trying to enact its own. Or, in the case of Donald Trump, those who have figured out that they can manipulate the situation.

        Yes, the Republicans have seriously damaged their already sullied brand. They’re just too afraid of their base to do anything about it. After all, holding on to power is still more important than doing the right thing for their country. The few decent ones who feel differently aren’t even bothering to run for re-election anymore.

      • Jill, this is why blind allegiance to a person you know is walking you down a perilous is highly frustrating. Read excellent foreign affairs reporter Trudy Rubin’s piece this week on the attack on NATO and the EU playing right into the hands of Putin and Xi.

        I think the GOP may need to bifurcate to go forward. It is so at odds with its mission. I wrote about farmers declaring bankruptcy at 50% or more of the previous year. Today, I learned dairy farmers are in crisis, in part due to slowed global markets due to tariffs. We cannot say MAGA as so many are in jeopardy by the tariffs.

        This why the GOP wants to make this election on AOC. Keith

      • Mary, you speak the hard truths that need to be said. Yes, both sides lie, but it is not even close to parity, with the GOP using its midinformation networks to tell their stories.

        I like the “feedback loop” reference. Two other tools that should be mentioned are two groups the average American does not know about. ALEC and Sinclair Broadcasting. The latter owns a significant percentage of local TV stations and require their newscasters to read standard copy on national issues of note. People do not recognize they are hearing opinion. ALEC is funded by the Koch Brothers and provides state governments with cookie cutter legislative templates on issues such as voter suppression, fossil fuel development, etc.

        To people like Putin, the feedback loop is like shooting fish in a barrel. He can easily disinform a lot of people. This is a key reason too many people don’t realize the President is not very truthful.


  1. The “unknown” author of this note deserves two thumbs up and a standing ovation, although they will have to be given separately. Stabilizing the ACA needs to be addressed now, it’s already past the sooner or later stage. Thank-you for sharing this enlightening note!

  2. Note to Readers: Since I recently wrote on radical kindness, I feel the need to explain why I am critical on occasion. Two points. It is highly frustrating when regular people have to pay the price of political gamesmanship. In states that did not expand Medicaid, if you work part-time, but make less than a certain amount, you do not have access to affordable reasonable coverage.

    The other is I have summarized these issues time and time again with politicians. I pleaded with the GOP to not repeal the ACA, but improve and stabilize it. It is highly frustrating that they chose to be political than help people. The focus is way too much on whether a certain position is a winning one politically. That is not governance, in my view.

  3. Dear Keith, Jill and Friends,

    I love this analysis as it explains the undercurrents in the GOP politics of today. Those GOP legislators need to be able to act on their own consciences but they are barred from this because of fear of its base of voters, and the mega GOP ‘dark money’ donors.

    The ACA is a case in point. Senators knew that killing it in 2017 would cost them politically, but they went along for the ride to please the donors. By killing Obamacare they would have more monies for their beloved tax cuts bill. I keep reminding folks that Obamacare was saved from the death penalty by 1 senate vote from Senator McCain. This is when they paid for the tax cuts by adding to the US deficit of a minimum of $1.5 trillion dollars over 10 years.

    This attempt to kill Obamacare by GOP lawmakers and all they’ve done to weaken it should be #1 advertisement against all GOP candidates in 2020.

    Then we come to the president’s declaring a ‘National Emergency’ over the funding for his SW border wall which requires him to pilfer monies from funds set aside by Congress for other projects, needs.

    There should be ads against any GOP lawmaker running for reelection who does not vote to kill this national emergency as stated in the current House Resolution crafted to end it. They all know that this is wrong, wrong, wrong.

    Hugs, Gronda

    • Gronda, many thanks. I think direct questions and follow-ups to Republican leaders, including the President:
      – Healthcare
      – Climate change
      – Debt
      – Jobs retraining

      and, so on. I would counter any lies and ask for them to confirm aources. There are too many lies being used to support bad decisions.


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