Obamacare replacement only a blast from the past

As President Elect Donald Trump stands ready to take the oath of office as 45th President this Friday, the dialogue on Republicans’ long awaited repeal of Obamacare, President Obama’s signature health care legislation, has risen to a fever pitch. You would have thought that, after six years and about 60 continuous votes to repeal the law, Republicans would have had a proposal ready to pull off the shelf and say, “Here it is. Here is our replacement!” It appears it is much more difficult to construct than to destruct. Frankly, it would seem that the most obvious source of opposition to the Affordable Care Act has been that it was proposed by Obama.

High among concerns for citizens who are insured are believed provisions to permit insurers to deny coverage for preexisting conditions. This concern is denied by many Republicans. Although President-Elect Trump has promised there will be “insurance for everybody” we do not seem to know even at this late date what shape that might take.

Recognizing this as background, an interchange took place Thursday night between Speaker of the House Paul Ryan and questioner Jeff Jeans, a member of the public, during a Town Hall meeting.

Mr. Jeans began his statement by saying he had been a lifelong Republican and a small business owner but was diagnosed with cancer and given six weeks to live. He had opposed the Affordable Care Act as a business owner but, after his diagnosis, was able to obtain health insurance through the law he had opposed where he could not receive coverage or treatment otherwise. He interrupted Speaker Ryan to state, “I want to thank President Obama from the bottom of my heart because I would

be dead if it weren’t for him.”

Ryan responded that Congress would replace Obamacare with “something better.” That something better he proposed was State High Risk Insurance Pools. Here I would interject State High Risk Insurance Pools are a “blast from the past.” I do know. If you have worked with clients, as I have, who have tried to obtain health insurance prior to the ACA, you would know what I mean.

These pools were tried. They did not work. They had waiting periods, and/ or extraordinary premiums or deductibles and they definitely did not cover everyone who needed health insurance. To suggest that the ACA could be replaced by high risk insurance pools when they have been tried and failed would be like someone, having purchased a new Model T Ford when cars were first introduced, stating, “I can’t figure how to handle a clutch so I have a great new idea that will provide transportation for everyone. It is called horses and carriages!” This is where some personal background would be helpful.

I am also a small business owner as an attorney. I admit that initially I moaned and groaned regarding the plan known as SHOP under the ACA, which is the small business owner’s version of the Marketplace. It was difficult to navigate the website. I did not have an insurance agent to help me because insurance agents could not – one major flaw I believe is still present in the act that could have been corrected. The changes were annoying and frankly it was annoying that it was change – something people might keep in mind when they believe that change in and of itself is good.

Then something amazing happened. I actually found the next year it got easier. The premiums rose but they rose slightly and very consistently with the way my office premiums rose when we were dealing directly with insurers anyway. We were fine.

It reminds me of an easy comparison. As a television viewer I sometimes come to be devoted to a certain series. I follow the characters and the story line and one day the network eliminates it and replaces it with another. For awhile I am annoyed but then I get used to the new replacement and get involved in another story line.

Then in a very short time the network cancels the new series saying there were insufficient viewers. Some things take time. The ACA definitely needed improvements and adjustments – something that Obama himself readily admitted.

Now, instead of correcting and adjusting we are talking about going back. Is this the best way to go? Suppose we had done the same with Social Security or Medicare and moved backward. What would have been the result?

For more, listen on Wednesdays at 4 p.m. to radio WCHE 1520, “Planning Ahead,” with Janet Colliton, Colliton Elder Law Associates, and Phil McFadden, Home Instead Senior Care. Janet Colliton, Esq. limits her practice, Colliton Elder Law Assocs, PC, to elder law and estates with offices at 790 East Market St., Suite 250, West Chester, PA., 19382, 610-436-6674,