GOP defense of health plan entering its own death spiral
Newresearch debunks yet anotherRepublican fabrication about the Affordable CareAct.
According to a report Monday fromthe Kaiser Family Foundation, insurers in theACA marketplace earned twice as much per policyholder year over year in the first of three months of 2017. Researcher Cynthia Cox predicts the companies will make a profit this year after repeated losses since the marketplaces began operating in January 2014.
Yet PresidentTrump and otherRepublicans have claimed the health care lawis in a “death spiral.” SenateMajority Leader MitchMcConnell, R-Ky., is pushing a wretched replacement, based largely on GOPmyths about theACAandMedicaid. Health andHuman Services SecretaryTom Price claimed thisweek that the situation for themarketplaces has “never beenmore dire.”
Cox, however, said, “There’s no evidence of a death spiral here.” She theorizes that insurers finally have set prices high enough to make money off sicker enrollees but not so high that healthy people forego insurance and pay the fine for not obtaining coverage. Overall, insurers have said that new signups had more health problems than the companies anticipated.
Price based his comment on news that 38 percent fewer companies plan to offer coverage next year on the federal marketplace. Florida and 29 other states use that exchange because they didn’t set up their own. But theTrump administration deserves part of the blame.
UnderTrump, the government has shownless interest in enforcing the individual mandate. The administration also has refused to reimburse companies for billions in assistance to less-affluent policyholders. McClatchyNews Service quoted the Oliver Wyman consulting firm as saying that as much as two-thirds of 2018 rate increases “will be due to the uncertainty surrounding these two market influences.” According to the Congressional Budget Office, failing to enforce the mandate could raise premiums 20 percent.
That’swhy four Democratic senators thisweek sent a letter toMcConnell offering four changes to the lawthatwould stabilize the marketplaces. EvenMcConnell told aKentucky audience during the congressional recess, “Ifmy side is unable to agree on an adequate replacement, then some kind of action with regard to the private health insurance market must occur."
McConnell, though, also continues the Republicans’ attempt to hide the reality of their plan. In response to criticism of the proposed one-third cut inMedicaid spending over 20 years, McConnell said no one “currently” onMedicaidwould lose that coverage.
But under the bill, those cutswould not hit until 2021– afterTrumpandRepublicans who voted for the billwould face reelection. As TheWashington Post’s factchecking staff noted, there’s noway to tell who onMedicaid nowmight be onMedicaid in four years.
We do know, however, that many of those will be children. Fifty percent of American children get health care coverage underMedicaid or the Children’sHealth Insurance Program(CHIP). Combined, they have reduced the uninsured rate for children to 5 percent.
Those at-risk children are concentrated inTrump Country. ALos Angeles Times analysis showed that theGOPhealth care billwould fall hardest on the nation’s 780 most rural counties. Of those, 617went for Trump. “There is just noway,” aWestVirginia physician told the paper, “to cutMedicaid on the scale that they are talking about and avoid hitting kids . . . Itwould be food or health care for a lot of these families.”
It remains a puzzlewhy so manyRepublicanswant so much to pass a bill that would so devastate the voters who put Trump in office and helped theGOPkeep the Senate. McConnell’s home statewould lose the largest share ofMedicaid money— 58.5 percent. Nextwould comeWestVirginia, whichwent bigger forTrumpthan any state exceptWyoming.
Floridawould lose “only” 34.4 percent, since this state didn’t expandMedicaid. The serious damage in Floridawould come frompeople on the exchange losing coverage.
As with immigration reform in 2013, there’s a chance for bipartisan compromise. It could improve the Affordable CareAct. Republicans, though, would have to accept the law, not repeal it. Apparently, they would prefer to lie rather than compromise, but the facts are catching upwith them.
Randy Schultz’s email address is randy@bocamag.com.