MARK KARLIN, EDITOR OF BUZZFLASH AT TRUTHOUT
Obamacare has been a singular obsession for Donald Trump and the Republicans in Congress since its creation, signed into law by President Barack Obama on March 23, 2010. In the mouths of the GOP, the health insurance program has taken on a monstrous image, as though it were a monster preying upon Americans. It has been a tragically intractable attack on a healthcare insurance system that -- although far from ideal -- has assisted millions of people in the US.
Despite the ongoing attacks from the GOP, it is worth noting that Obamacare was no progressive innovation: Its structure is based on a system put into place and championed by Mitt Romney when he was governor of Massachusetts -- and implemented with the support of the George W. Bush administration, which helped fund it.
However, Trump and Congress recently took another swipe at the Affordable Care Act (ACA), and according to Politifact, their action may destabilize the entire insurance market:
The Republicans' successful drive to pass a massive tax bill allowed President Donald Trump to take another slice off of the Affordable Care Act. Effective 2019, the sweeping tax package repeals the penalty on people who might be able to afford health insurance but choose not to buy it. The individual mandate affects a relatively narrow sliver of Americans, but it has been a pillar of Obamacare.
The mandate was the stick to herd more people -- healthy people -- into the insurance pool. That would spread the risk, keep premiums down and produce a stable insurance market.
Politifact explains why this provision was so important: It offset the requirement that ACA and commercial insurance policies cover pre-existing conditions. The premise for this policy is that if healthy -- primarily younger -- individuals were fined for not having insurance, insurance pools under Obamacare would not just consist of people in severe need of health care coverage.
Since it became law nearly eight years ago, the ACA has given insurance companies a framework to work within. Obamacare has existed alongside employer and private insurance policies without any major friction. Many of us support a Medicare for all health insurance system -- Bernie Sanders is sponsoring a bill for one in the Senate -- above Obamacare's profit-driven approach. Still, Obamacare has provided immediate relief for those with pre-existing conditions and those who could not find affordable healthcare plans on the open market. It also mandated specific preventative medical procedures to make medicine more proactive, procedures that Congress and Trump are trying to deregulate.
The private insurance market has not suffered under Obamacare. In fact, according to CNBC, "Combined, the nation's top six health insurers reported $6 billion in adjusted profits for the second quarter" of 2017 alone.
CNBC also reported, in December, that despite the withering assault on the ACA, enrollment was strong for 2018 policies. Mind you, that is despite all the enrollment obstacles the Trump administration put in place:
Final open enrollment numbers for the Obamacare federal marketplace were surprisingly strong, with 8.8 million customers selecting a plan by the sign-up deadline, officials said....
In the final week of enrollment, 4.1 million people signed up on Healthcare.gov, with 1 million of those being new customers, according to snapshot figures published by the Center for Medicare and Medicaid Services.
By any standard, this is a robust indication that the need for the ACA is strong, and it likely would have seen an even larger enrollment this year if it were not under such attack.
Indeed, in California, which had its enrollment periods extended, the Associated Press (AP) reports "California’s state exchange, the nation’s largest, has reported more than 1.2 million renewals for 2018 and an additional 342,000 new customers." Those are not even final figures, as registration still continues in the Golden State. The AP also notes that Minnesota set a record for enrollment on its state exchange despite a shorter period for signing up this year.
It is ironic that the Republicans and Trump, who champion a market-driven economy are so dismissive of consumer demand for a needed product. Furthermore, by trying to dismantle the ACA and its health care protections, the Republicans and the White House are returning the US to a broken insurance market, at a time when the ACA has been stabilizing insurance coverage. Make no mistake about it, the continued dismantling of the ACA is going to throw insurance coverage in the US into turmoil.