Posted: 07/06/15 15:35
by Dave Mindeman
There is this constant Republican background noise that turns over every stone they can find that might hold a criticism for health insurance via the ACA.
They have been focusing lately on premium increases. So let's try to introduce some more factual reasoning into this.
First of all, premiums in health care have been increasing forever. The reason we have tried so hard to reform health care and the reason why we passed the ACA is because health insurance premiums have always been increasing faster than inflation, the economy...everything.
And these increases were happening while we have had an alarming number of people who were uninsured. What I have to ask Republicans is, why do you want to go back to that? If you want to repeal the ACA, then you will be dealing with the original problem and so far, I have not seen anything resembling a solution to that from the GOP.
But let's get back to current premium increases.
These increases are coming from our old friends the insurance companies. We still have a private insurance health care system....it just has more regulations and mandates which get more people covered -- but make no mistake, the insurance carriers still set the premiums.
Now, on the one hand, some of these increases are understandable. When the exchanges first went into effect, the insurance companies lowballed the numbers with some expectation of higher volume. So, now that they are getting a fuller picture of the ACA world, they are going to be getting back to being realistic. Health care is still expensive and complicated.
Another reason comes from the fact that the people with pre-existing conditions which were unfairly left out of the insurance pool, now have a guarantee to be included. This brings in a number of sicker people. The idea behind the ACA is that the mandate to cover everybody also involves covering people who are healthy and have not purchased insurance in the past. That would hopefully balance the pool.
Some of the delays in mandates for smaller businesses and other delays have kept some of the healthier people out of the pool. Obviously that will unbalance things and cause premiums to rise. But that should be self correcting as we go forward - (now that we really can go forward after the Supreme Court decision).
Speaking of the Supreme Court, there was also a level of uncertainty which allowed many people to delay getting into ACA coverages because the expectation was that it might all go away anyway. That is now an answered question as well.
I have these Twitter arguments with conservatives who complain about the increasing premiums and when I tell them that my premium is about 1/6 of what it used to be, they come back with - "but that is with a subsidy isn't it". To which I say, "So what?" The whole idea of the ACA is to utilize subsidies to make insurance more affordable. This system is predicated on subsidies as part of the system as a whole. It is basically a grandiose "means testing" method of getting people insurance. I don't think anyone should have to apologize for that. It is how the playing field can be leveled so that we do not have so many uninsured.
And that is where the ACA is working so well. The number of uninsured is dropping each time a poll or analysis is taken. The ultimate goal of the ACA is working.
We still have to wait a few years for the premium aspect to get sorted out. Yes, premiums have gone up right now - but the reality is that without the ACA, they probably would be worse.
I'm sure the Republicans will find more stones to upturn, but this one could have been left under that rock.