Las Vegas Review-Journal

Contrary to Republican­s’ claims, Obamacare is not collapsing

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The biggest lie that President Donald Trump and other Republican leaders have been repeating about the Affordable Care Act for years is that it is collapsing, imploding or exploding. The truth is that the law is actually working reasonably well, and even the part that has shown the most weakness — the health insurance marketplac­es — has been stabilizin­g.

Insurers that sell policies to individual­s and families are doing better financiall­y than in the first two years of the ACA. They are also doing better than they were before the federal and state government­s opened the marketplac­es in 2014, according to a Kaiser Family Foundation report published on Monday. The data showing improvemen­t confirms earlier reports by Standard & Poor’s, the Congressio­nal Budget Office and research groups that were based on 2016 numbers. While there are still problems in marketplac­es in some states, the ACA, or Obamacare, is hardly coming undone.

Yet Republican­s in Congress and the Trump administra­tion continue to peddle horror stories about the ACA as they try to gather the votes for repeal of major provisions of the law. To that end, the Senate majority leader, Mitch Mcconnell, presented a new version of his health care bill on Thursday. His earlier proposal would take health insurance away from 22 million people and raise premiums for millions of others, according to the CBO.

Many Americans who do not get health insurance through employers have been frustrated with the marketplac­es. The launch of Healthcare.gov by the Obama administra­tion was disastrous. And the insurance policies have high deductible­s and premiums that are unaffordab­le to many people, because the law did not provide enough subsidies to middle-income families. Insurers did a poor job designing their policies and suffered big losses initially, forcing them to raise premiums even more. Republican­s also weakened the markets by repealing provisions meant to stabilize them and by filing a lawsuit to reduce federal subsidies. Despite these challenges, more than 10 million people have bought policies on the marketplac­es. Most have been protected from big premium increases through subsidies.

Insurers suffered big losses in the early years, in part because many families who had not had comprehens­ive health insurance for years signed up and needed more care than the average family. Now, the medical costs for people with marketplac­e plans are more in line with those for people insured through employers.

But insurance markets in some states, like Arizona, Iowa and Tennessee, remain fragile, and few insurers are willing to sell policies there. There are several reasons. It is harder to do business in rural areas where there are few customers and fewer providers. Insurers fear that the Trump administra­tion will make good on the president’s threats to stop making subsidy payments. And in some places, a few very sick and very expensive patients have driven up the cost of insurance.

Mcconnell’s bill would make things

presented a new version of his health care bill on Thursday. His earlier proposal would have taken health insurance away from 22 million people and raise premiums for millions of others, according to the Congressio­nal Budget Office. How many would lose insurance under the newest iteration has not been calculated. But those losing care would be sacrificed, all for the Republican­s’ goal of repealing their hated Affordable Care Act, enacted during President Barack Obama’s tenure. much worse. It would greatly reduce subsidies available to help people buy insurance. The new version did not strike a terrible proposal by Sen. Ted Cruz of Texas to allow insurers to sell skimpy policies that are cheaper but do not meet the requiremen­ts of the ACA, if they also offer ones that do. That means comprehens­ive plans would be bought mainly by people with expensive medical needs, like pregnant women and cancer patients, and push premiums up. That would lead to fewer people buying policies, the industry group America’s Health Insurance Plans said Wednesday.

The ACA is not perfect, but its problems are fixable. In fact, 71 percent of Americans want Republican­s to work with Democrats to improve the law; just 23 percent want lawmakers to repeal and replace it, according to a Kaiser poll. Democrats have said they would be willing to work with Republican­s to strengthen the law. But Mcconnell and his party have become so blinded by their rage against Obamacare that they are losing sight of what ought to be their goal: safeguardi­ng the health of their constituen­ts.

 ?? ALEX BRANDON / AP ?? Senate Majority Leader Mitch Mcconnell of Kentucky
ALEX BRANDON / AP Senate Majority Leader Mitch Mcconnell of Kentucky

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