Introduction by Smith Young “:)” The only thing missing is that the first priority is to repeal Obamacare, otherwise an excellent article.
Denver Post – Yes, Obamacare Can Be Replaced by Something Better
by Krista Kafer
January 22, 2017
You can have filet mignon at a five-star restaurant or eat out of the dumpster: those are your only choices for dinner.
Absurd, you say — rarely does life present only two extreme options. You’re right. So when activists frame the argument as Obamacare or no care, reject it as a false choice. No law is perfect; our legislators can repeal and replace the Affordable Care Act (ACA) with a better law.
Obamacare helped 14 million Americans gain health insurance through Medicaid expansion and the government exchanges. It did so, however, at a very high a cost; millions of Americans lost their health insurance because their plans did not conform to new mandates, premiums and deductibles went up, and we now have fewer insurance plan options. The law has reduced choices and increased costs.
At the heart of the law’s problems are faulty premises. Among these is the idea that elected officials, bureaucrats, or lobbyists should determine what plans cover. In other words, the few should determine what is best for the many. This is wrong. Individuals have different needs and priorities. I don’t mind paying for my birth control and mammograms out of pocket as I did for years before the ACA. Another person may want to pay a higher premium and have those products and services covered. I have health problems and my health is a high priority, so I’m willing to pay more and spend less in other areas of my life. Other people may have other financial priorities and needs and want less coverage. I shouldn’t decide for them. They shouldn’t decide for me. But that’s what one-size-fits-all government mandates do; they make our choices for us and drive up prices to cover services we may not want.
Congress and the new administration through regulatory reform should eliminate such mandates. This would enable insurance companies to offer more options at different prices. Lower-priced options would help small businesses, able-bodied adults currently on Medicaid, and those who are uninsured purchase health insurance for themselves or their employees. Congress could create a national exchange for accessing plan options and thereby sidestep costly state mandates on coverage. And rather than subsidize such plans by paying insurance companies, Congress could offer tax credits based on age or income for the purchase of plans. Currently, individuals who purchase health insurance on their own do not receive the same tax advantages as employers do when they purchase plans for employees.
Another flawed premise in the ACA is the idea that all people with pre-existing conditions want insurance. Because I have a lot of pre-existing conditions, I maintain continuous coverage. People who jump on insurance only when they need coverage don’t want to be insured from health costs, they want other people to pay for their health costs. That’s not fair. This behavior drives up the cost of insurance and is one of the main reasons insurers are dropping out of the exchanges. More than a dozen Colorado counties are down to one insurer on the Colorado exchange.
That doesn’t mean that Congress should toss out the ACA’s guaranteed issue provision. Rather, lawmakers should extend the Health Insurance Portability and Accountability Act (HIPAA) to cover Americans in the individual market. As long as people maintain continuous insurance care, they should be able to switch plans without losing coverage for pre-existing conditions just as people in the group (employer) markets. Congress could also expand the kinds of group markets available beyond employer-based. Those who choose not to maintain coverage will incur a higher cost. That’s only fair. For those true hard cases, state high-risk pools will ensure Americans with significant health issues don’t falls through the cracks.
These solutions and others fill thousands of pages of legislation introduced over the past six years. Republicans don’t have a replacement plan; they have plans. They need only to unify around a single plan and pass it. Don’t believe the fear-mongering; no one who wants to buy insurance will be left behind. Instead, implore Congress to replace the ACA with something better.
Krista Kafer (firstname.lastname@example.org) is co-host of “Kelley and Kafer,” which airs 4 to 7 p.m. weekdays on 710 KNUS.