Yes, we can repeal ObamaCare and still protect the sick
Democrats are warning that once ObamaCare is repealed, people with serious illnesses won’t be able to get health insurance. President Obama says repeal will mean going “back to discriminating against Americans with pre-existing conditions.”
That’s fake news.
The truth is, all Republican proposals to repeal and replace the Affordable Care Act protect people with pre-existing conditions.
Likewise, they all eliminate ObamaCare’s invidious discrimination against healthy people. ObamaCare forces the healthy to pay the same premiums as the chronically ill, whose medical costs run 10 times as high. That’s because a mere 5 percent of the population consumes half the nation’s health care.
To see how the GOP approach would work, look to Alaska, a state that seized the initiative when healthy consumers rebelled against their soaring ObamaCare premiums.
The burden of caring for 500 chronically ill patients was making ObamaCare unaffordable for all 23,000 Alaskans in the individual market. They faced 40 percent premium hikes for 2017. So in June state authorities created a separate “high-risk” pool for the sickest people, with the cost shouldered by all Alaska taxpayers, instead of being thrust on buyers in the individual insurance market. As a result, premium hikes were kept to single digits.
The Alaska remedy is a microcosm of what congressional Republicans propose for all 50 states.
High-risk pools are not a new idea. Before ObamaCare, about 250,000 people a year were denied coverage for health reasons by major insurers, and nearly all of them enrolled in high-risk pools in the 35 states that offered them. (Sadly, New York wasn’t among them, a major reason premiums were so high here.)
In 2010, the ACA established a temporary high-risk pool for people not being served by the state pools until the ObamaCare exchanges opened. About 135,000 enrolled.
That suggests that as many as 500,000 people across the nation will likely need high-risk pool coverage once ObamaCare is repealed.
Subsidizing high-risk pools in all 50 states would cost about $16 billion a year. That assumes spending about $32,000 on each person helped — the same as in the federal temporary risk pool.
Now, $16 billion sounds like a fortune. But it’s less than half the $43 billion spent on ObamaCare plan subsidies last year. And it’s money far better spent, because it directly helps the sickest among us.
Some GOP lawmakers are proposing spending less on high-risk pools in order to also offer subsidies to healthy buyers. They should reconsider.
Fully subsidizing the medically needy in risk pools will stop premiums from skyrocketing in the individual market. Then, healthy people will be able to buy coverage at reasonable prices that reflect their own expected health needs. A good deal for the sick and for the healthy.
So much for the fearmongering that repealing the ACA will victimize millions with pre-existing conditions. In fact, ObamaCare architect Jonathan Gruber recently analyzed which provisions of the law expanded coverage to millions more Americans. Even Gruber’s analysis attributes none of the gains to changing the rules regarding pre-existing conditions.
Most people with pre-existing conditions already had coverage before ObamaCare. The pre-existing conditions crisis was largely concocted to sell Obama’s health law. President Obama even fibbed about his late mother, claiming she was hassled for a pre-existing cancer. Not true.
In fact, for people with pre-existing conditions, such as cancer, ObamaCare spells trouble. Most plans severely limit choice of hospitals and doctors, excluding specialty hospitals like Memorial Sloan-Kettering Cancer Center in New York City. Forcing a cancer patient to change oncologists is a life-or-death issue. That’s why patient advocates and several state health commissioners opposed closing high-risk pools.
High-risk pools are a key part of what will replace ObamaCare. They’re a transparent method of subsidizing care for the sickest among us, while keeping premiums affordable for the rest of us. Good riddance to ObamaCare’s devious scheme to force the young and healthy to overpay for insurance. No one was fooled.
Betsy McCaughey is a senior fellow at the London Center for Policy Research.