Thursday, October 27, 2016

Obamacare: Progress Worth Fighting For

You might have heard on the news recently that Obamacare “isn’t working”.

Put simply: that’s not true.

For the first time, more than 90% of Americans have healthcare.
For the first time, 20 million who didn’t have insurance before now have it.
For the first time, those with preexisting conditions can shop for affordable insurance.

And although premiums in 2017 are scheduled to increase, this is a normal – however unfortunate and inconvenient – part of market dynamics. It is also important to note that what premiums are doing is different from what people are actually paying.

While premiums might be going up in the short term, so are the tax credits available to consumers. In fact, thanks to these tax credits, nearly 80% of those who either sign up for the first time in the marketplace or change plans in the marketplace will only end up paying between $50-100 a month for insurance.

For those who get coverage through their employers (like most Americans), they will now be getting better quality of care, as insurance companies can no longer deny coverage, must include maternity care and preventative care at no additional costs, cannot place lifetime caps on your coverage, and must spend 80% of your premiums on actual care. That’s more bang for their buck.

Plus, in the long-term, once the market balances out and healthier people get enrolled – economies of scale will kick in. Costs will lower for everyone because people will get healthier, make less ER visits (that taxpayers pay for), and have more free-market competition between insurance companies.

Market dynamics take time. That is exactly why we cannot talk about “repealing Obamacare”. Instead, we need to talk about “improving Obamacare” by:

1. Ensuring that healthier, younger people get enrolled in the Marketplace to balance the risk pool.
  • If you have not already, I would recommend that, at the least, you take a look at Healthcare.gov. It's very consumer-centered and user-friendly. You can shop around multiple issuers and multiple plans to see if there's a viable option for you. Most people can also find up to 30 different plans and use tax credits to reduce any potential financial burdens. Open Enrollment goes from Nov.1-Jan.31.
2. Ensuring that we expand Medicaid to ensure premiums decrease for consumers.
  • Specifically, there are 19 Republican Governors that have refused to expand Medicaid in their states, thus denying affordable healthcare to an estimated 4 million Americans. This is partisanship we cannot afford, as marketplace premiums in those states are about 7% higher than in states that have expanded Medicaid.
3. Making Medicare more sustainable.  
  • Medicare spending comes at a great cost to taxpayers. So shouldn’t we make sure that our taxpaying dollars are being spent wisely? Shouldn’t we ensure that we are not paying twice to fix the same medical conditions?
  • That means making sure that each dollar is spent on improving quality of care, not quantity.
  • If you have ever visited the hospital for a medical procedure, you will notice that – often times – there can be significant overlap in services. You might have to see several different clinicians, who might order duplicate x-rays or blood tests. This drives up healthcare costs, results in fragmented care, and creates minimal coordination between clinicians. Obamacare begins to fix this problem.
  • Also thanks to Obamacare, less of our taxpaying dollars will go to those hospitals that have a high remittance rate (i.e. patients who return within 30 days of discharge for the same condition). This free-market approach ensures that clinicians get paid for what they provide and reach certain health requirements to get reimbursed. According to the non-partisan Congressional Budget Office (CBO), this will save taxpayers $7 billion over 10 years. It will also lead to greater collaboration among healthcare professionals, thus better quality of healthcare.

Obamacare might not be a perfect law, but it is a significant improvement from the system we had before.

That is progress worth fighting for.
That is progress worth voting for.