Thursday, December 15, 2016

Opponents should be more interested in how the ACA benefits people, rather than in overblown claims on how it "hurts" them

The Affordable Care Act—the so-called “Obamacare”—continues to be the subject of the  highest hypocrisy by its opponents. Polls show belated majority support for the ACA as the reality starts to sink in that it actually may be repealed and not replaced, since no one in the Republican leadership has indicated that they actually have agreement on any  “plan”  to replace it now, or have a “time table” to come up with one. It is ironic that the ACA as it is now constituted is essentially the same as the Republican “alternative” in 1993, but naturally they oppose it now because the “other” party is associated with it. 

House Speaker Paul Ryan’s “Better Way” plan would do away with the individual mandate, which affordable care supporters will be a huge mistake, because it will result in higher premiums for low-income people who will not be able to afford it. His “plan” offers “incentives” to maintain continuous coverage, which in reality will only allow insurance companies to take advantage of this and premiums spiral out of control, and those who try to get a different plan will be “penalized.”  Ryan’s claim that he will offer a plan that will not make those already on an ACA plan “worse off” thus will be, and to those currently on an ACA plan, it is hard to stomach the mendacity. Ryan’s “plan” doesn’t have much support, of course, and Donald Trump has said that he won’t take a “wrecking ball” to the act. But as usual, Trump speaks out of both sides of mouth; his Health and Human Services nominee, Rep. Tom Price, is another extreme opponent of the ACA who has nothing good to say about it. 

Whatever Ryan does, of course will be subject to, as the New York Times’ Frank Bruni recently wrote, rummaging “through his wobbly endoskeleton and make fresh acquaintance with his spine. Until that happens, this sadly groveling Boy Scout will be lost in the woods.” But at least he has a “plan,” fake or not; Senate Republicans have no plan at all, and never did. People should waste no time in demanding that Trump and the Republicans don’t touch the ACA at all until they have a replacement that does essentially the same thing it does. Price’s claim that "The American people are paying more for health care and getting less – less access, less quality, and fewer choices” because of the ACA is high hypocrisy on many levels; health care before the ACA was out-of-reach for millions of Americans, with costs spiraling out of control by as much as 20 percent a year, and nearly all insurance companies  refused to offer individual coverage. People on the ACA will doubtless say that Price not only doesn’t have a clue about what he is talking about, but his insensitivity to the problems of low-income people (which he shares with most on the Right) is inhuman.

Meanwhile, insurers claim that they are being “hurt” by spiraling costs supposedly induced by the ACA, but as Wendell Potter of points out, they are talking out of both sides of their mouths as well. He writes this past March that rather than “killing” the health insurance industry, “The first seven years of the Obama administration have been ‘yuge’ for the health insurance industry, to use one of The Donald’s favorite words.” In fact, “unbelievably ‘yuge’ for people who own stock in health insurance companies.”  For example, “On Friday, February 19, shortly after the stock market closed for the week, the government announced that it was giving a big raise to the private insurance companies that participate in the Medicare Advantage program, the private alternative to traditional Medicare. Based largely on that news, investors rushed to buy as much of the health insurance companies’ shares as they could get their hands on. By the time the market closed on Friday, February 26, just seven days later, Cigna’s stock was up 5.5 percent. Humana’s was up a whopping 8.1 percent. By comparison, the Dow Jones industrial average was up just 1.5 percent.”

Potter points that health insurance companies had “record-breaking profits” last year. Despite the fact that insurers like UnitedHealth had $11 billion in profit (after CEO Stephen Hemsley’s $66 million paycheck) thanks to investment spurred by the ACA, it says that it “might” opt out of individual exchanges because it lost $720 million on that part of its “business.” But as Potter points out, the ACA portion of its portfolio is actually only a small portion of its operations; on the other hand, “UnitedHealth has been making money hand over fist from federal and state governments, thanks to Obama, just as WellCare has. In fact, far more than half of the $157 billion it took in last year came from Medicare, Medicaid and other government programs (i.e., from you and me, the taxpayers).”

The reality is that the ACA has been beneficial to those who need it, and the “harm” it is causing is well overblown by those whose opposition to it is more a function of their politics and social attitudes. The bottom line is that we need decision-makers who have the long-term interests of the people and the country in mind, not a function of their bigotry. Unfortunately, “Obamacare” has been used to manipulate many voters dislike of Obama personally, and one suspects that many Republicans feel they have painted themselves into such a corner they can’t extricate themselves from without losing what little credibility they ever had on the issue.

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