When Congress failed to repeal the Affordable Care Act last month, President Donald Trump unleashed these hard-hitting words:
“I think we're probably in that position where we'll let Obamacare fail,” he said. “We're not going to own it. I'm not going to own it. I can tell you the Republicans are not going to own it. We'll let Obamacare fail and then the Democrats are going to come to us.”
Trump, who has called the ACA a “disaster” on multiple occasions, cites high deductibles, high premiums and health insurers leaving the healthcare exchange.
The ACA is in a death spiral, Republicans and others have said. A death spiral occurs when the options available to customers are too few and too expensive, so healthy customers opt not to purchase insurance, leaving only the sick to share costs.
Death Spiral Imminent
Earlier this year, Aetna CEO Mark Bertolini proclaimed the ACA is in a death spiral because too many ill were entering the exchange, raising insurer costs. This will force insurers to leave the market or take a loss in the markets, he said.
"There isn't enough money in the ACA today as it is structured – even with its fees and taxes – to support the population that needs to be served," Bertolini said.
An estimated 1 percent to 5 percent of Aetna’s customers share half the cost.
Insurers are expected to receive an estimated $7 billion from the federal government this year in cost-sharing reductions meant to defray the costs of insuring lower income customers.
So far this year, enrollment in unsubsidized plans during open enrollment has decreased 29 percent compared to the past four years. These individuals are paying their full insurance premiums out of pocket.
According to a report by Mike Farrah and Associates, the number of Americans insured through the individual insurance market dropped 13 percent to 17.6 million between March 2016 and March 2017. Of these people, 5.4 million opted to purchase their coverage off the exchange.
The report also found that 2.4 million people only have one healthcare plan option on the exchange. Last year, 227 qualified health plans had filed initial applications to offer coverage. This year, the number has dropped 38 percent to 141.
“This is further proof that the Affordable Care Act is failing,” said CMS Administrator Seema Verma. “Insurers continue to flee the Exchanges, causing Americans to lose their choice for health insurance or lose their coverage all together. These numbers are clear: the status quo is not working. The American people deserve healthcare choices and access to quality, affordable healthcare coverage.”
Republicans Against ACA
Republicans have been against ACA from the beginning. In 2011, the Republican National Committee posted in its website, “Obamacare and its unconstitutional mandate drives up health care costs, increases insurance premiums, hurts the quality of health care, raises taxes, and blows up the deficit.”
This view is still held by the GOP. Their arguments include:
•Costs will go up not down and people won’t be able to keep their doctors.
•Insuring more Americans will create a shortage of physicians and this will lead to longer wait times for service or doctors refusing patients.
•Emergency rooms will become more crowded from people seeking care.
•Small businesses receive penalties if they do not provide insurance to their employees.
•The federal debt will increase.
There is one other argument favored among Republicans, most vocally Sen. Rand Paul (R-KY), and that is the idea that the ACA is an entitlement program and that the federal government has no business insuring its citizens. Paul has said he will vote against any bill, even one proposed by his own party, if it’s an entitlement program.
Clearly, healthcare is a subject that is personal for many people, and illness and injury are events no one can escape. How and when the ACA dies is anyone’s guess, but its demise will effect every American.
When do you think ACA will hit rock bottom?
Photo credit: whitehouse.gov