Health care still a mess, and GOP's making it worse

Published on Tuesday, 5 June 2018 21:00
Written by the Washington Post

The Congressional Budget Office, Congress’ official scorekeeper, released last month a bevy of new projections about health-care coverage in the United States. The upshot is that the nation still faces huge cost and coverage challenges, and Republicans are making some of the direst problems worse.

The government spends a whopping $685 billion on nonelderly health coverage, which equals 3.4 percent of the economy. And costs are going up, fast. Federal health-care subsidy spending is set to rise by 6 percent per year for the next decade. This is not a result only of Obamacare subsidies; the federal government spends far more to subsidize the employer-based coverage most Americans get than it does Obamacare’s individual market insurance plans. For all the rancorous debate about the law, only 4 percent of Americans get their coverage on the Obamacare marketplaces.

Despite the spending, 29 million people, about 11 percent of the nonelderly population, lack health insurance. In 10 years, that number will have risen to 35 million.

The CBO’s 2027 estimate is about 5 million more people than the last time it ran the numbers.

Why the changed prediction? Because Republicans are sabotaging Obamacare. Between this year and next, an additional 3 million people will go without coverage because Republicans repealed the law’s individual mandate, which will drive healthy people out of the market and premiums up by an additional 10 percent. Another 3 million will lack insurance after a couple more years because of this effect.

Thankfully, the GOP sabotage campaign has not totally crippled the law. The CBO believes that Obamacare markets will be stable over the next 10 years in most places. Even so, individual market premiums will continue to rise, by 15 percent next year and about 7 percent every year after that through 2028. Some areas of the country may be worse off. A quarter of insurance buyers currently have only one insurer to choose from, a problem that could be made worse if the Trump administration’s sabotage efforts compel more insurance companies to pull out.

The CBO warns of the “substantial uncertainty” still roiling the market - the result, in our view, of purposeful mismanagement or incompetence on the part of the Trump administration and congressional Republicans. “That uncertainty may affect insurers’ decisions to participate in the nongroup market in future years, and such withdrawals could threaten market stability in some areas of the country.”

An election year might be an inconvenient time for Congress to reenter the health-care debate and shore up the system. But when those who end up uncovered get into a car accident or receive a cancer diagnosis, the prospect will be far more severe than inconvenience.

Bipartisan groups of lawmakers should be able to agree on market-stabilizing programs such as reinsurance, now. Republicans who voted for the calamitous tax bill, which included the individual-mandate repeal, have a particular duty to repair the damage they have done.



Posted in New Britain Herald, Editorials on Tuesday, 5 June 2018 21:00. Updated: Tuesday, 5 June 2018 21:10.