ACA needs tweaks, not repeal and replace

Recently I went in search of health insurance. I no longer enjoyed the benefits of an employer-sponsored plan and my payments into COBRA were astronomically high, so I was hoping to find something more affordable.

I decided to stop by a couple of brick-and-mortar insurance agency offices, to see what they could offer. What I encountered surprised me.

Turns out I was wrong to hope I’d find a less expensive policy, unless I wanted to go to a bare-bones policy with high deductibles and enormous co-pays, but that’s not what surprised me. Instead, I was taken back by the vitriol with which the two agents I spoke to had for Obamacare.

Two bigger supporters of “repeal and replace” you’ll not find. I listened to their complaints—one even volunteered that, by golly, she’s “not a social worker,” clearly in reference to the rising number of people signing up for Medicaid, thanks for the Affordable Care Act. (A majority of New Mexicans, and an even larger majority of children, are on Medicaid these days.)

If didn’t take me long to realize why these insurance agents are so against the ACA. It’s cutting into their business.

More than any other player in America’s healthcare system, the insurance industry is the power behind the push to rid the nation of the ACA. They’re the ones who really benefit from a free-market approach to health care, and they’re naturally opposed to anything that cuts into their considerable profits—and, up until recently, they found the perfect mouthpiece in the Republican Party.

Now, however, even Republicans must concede that Obamacare isn’t all bad. A few of them even placed the interests of their constituencies ahead of the insurance industry. Requiring insurance providers to cover people with pre-existing conditions, for example, isn’t something the GOP is willing to dump, even though that’s one of the biggest reasons why insurance premiums have gone up. That and the fact that when uninsured Americans could finally afford health insurance (thanks to Obamacare), they turned out to be sicker than anyone anticipated.

Turns out, many of the people who voted for Donald Trump and other Republicans are the same people benefiting from Obamacare, and that’s made some Republican lawmakers reluctant to do things like cutting Medicaid. Meanwhile, Republicans with an ideological objection to the ACA’s tilt toward universal health care find themselves beaten down by practical realities. You can talk “free market” all you want, but to a sick person, it’s all about getting better and paying the bills—something our so-called free-market approach as failed miserably at. That’s why health care bills are biggest reason for bankruptcies in the U.S.

But now, insurers have to provide more comprehensive policies—things like preventative care, mental health problems and treatment for addictions are now required benefits—and children can now stay on their parents’ health insurance policy until age 26. Thank the ACA for these added features.

The ACA attempts to extend health-care coverage to everyone, and so far it’s working, as millions more Americans are now insured. But it also raised rates for many in the middle class, and needs to be fixed.

Of course, you can blame the ACA if your insurance provider decided it couldn’t afford to upgrade your coverage to include the “10 essential benefits” now required by Obamacare. Or, you could blame your insurance company, for refusing to give up just a piece of its hefty profit margin to cover things like chronic diseases for you and your family. Greed is as greed does.

Another outgrowth of Obamacare is the state health exchanges, which have brought insurance to lower-income people who qualify for subsidized premiums but have done little for middle- and higher-income people who don’t qualify for a subsidy. People like me, who have made too much to qualify for assistance but too little to afford coverage that costs as much as a mortgage. Self-employed, lower-middle income individuals and families, I’d say, are getting hit the hardest, as, it seems, they always are.

That’s a good reason to tweak Obamacare, but not to repeal and replace it. Now that Republicans have embarrassed themselves thoroughly on the floor of the Senate, maybe they can revisit the issue with less hyperbole and more critical thinking. Perhaps they should focus on fixing what’s wrong, and keeping what’s right, with the ACA.

And for crying out loud, consider the people over the profits. This is more than an economic or political issue. For many, it’s life or death.

Tom McDonald is founder and editor of the New Mexico Community News Exchange. He can be reached at tmcdonald@gazettemediaservices.com.