Viewpoints from Craig Hasday
In a largely symbolic effort, House Democrats introduced a bill to modify healthcare laws. It’s too bad this one has no chance – some of the changes look pretty good and what we might get after the election power shift could end up much worse. The bill expands and protects Medicaid and reduces or eliminates premiums for the lowest earners and most vulnerable populations. It also clears up a technical error in the Affordable Care Act (ACA) that eliminated subsidies for spouses and children in the event the employee is eligible for employer-sponsored coverage (despite family coverage being unaffordable). If you believe, as I do, in incremental change, these are good changes. The law also eliminates the short-term health plans allowable under the president’s executive order, which undermines pricing stability on the exchanges.
There are many others addressing errors in the ACA that should be cleared up – a big one is finding ways to encourage competition.
While this was a primary objective of the ACA, it hasn’t worked. A study by Mark Farrah Associates shows that the market share of the top-six ACA health insurers increased from 30% in 2015 to 50% last year, and during the same period, enrollment dropped from 16.7 million to 12.4 million enrollees. BenefitsPRO magazine recently highlighted that in 2020 the cost of ACA premiums and deductibles for a family of four purchasing coverage is now $25,000, with average monthly premiums of $1,437 and average annual deductibles of $7,767. It is clear the vast majority of health plan purchasers on the exchanges get subsidies – otherwise, costs are unaffordable.
Whether we end up with Democratic or Republican control, there is no doubt that change is upon us.
Legislators at the federal and state level and the courts are very active. In my view, a positive result is a district court’s ruling to turn down an attempt by the American Hospital Association to block the Trump Administration’s efforts to require hospital price transparency. Far more transparency is needed to eliminate the arbitrary pricing system for hospital charges that now exists.
The individual marketplace is essential to preserve healthcare as we know it, so is finding affordable alternatives – especially since the numbers of uninsured are sure to rise significantly due to COVID-19-related unemployment and economic slowdown. And state and federal budget dollars are being squeezed hard to prop up the economy. Healthcare is at a volatile crossroad and so much depends on election results.
Let’s hope this doesn’t become a high-powered game for politicos. The focus must remain on how essential healthcare is to all Americans.
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