While the nation was focused on migrant caravans, mail bombs and President Donald Trump’s disgusting tweets last week, his administration was making another big change to the Affordable Care Act, also known as Obamacare. The new plan would give states far more flexibility in regulating health-insurance markets within their borders. That sounds like a good thing. It is not.
Obamacare reorganized the market for individual insurance plans - that is, coverage people do not get from their employers or directly from the government. The law recognized that there are only so many ways to get people with preexisting conditions onto the comprehensive plans they need. The government could insure them directly, at high taxpayer expense, or it could mandate that everyone carry decent, private health-care coverage. With many people, healthy and sick, in the system, premiums overall would be contained and everyone would have quality health insurance that would cover expected and unexpected medical costs.
Republican state leaders, the GOP-majority Congress and the Trump administration have tried to sabotage this model.
They eliminated the mandate that people buy insurance. They legalized skimpy insurance plans and now Republicans’ new rules could allow states to subsidize people buying skimpy plans, enhancing the incentive for healthy people to desert their comprehensive coverage.
The fact remains that there are very few ways to adequately serve people with preexisting conditions. The government either needs to pump lots of money into directly subsidizing their care or it must foster insurance markets to which everyone contributes.
The law is premised on the latter option. It is a good model, in part because it provides a path for nearly everyone to have comprehensive coverage, which should be a minimal standard in the world’s largest economy. Republicans should stop trying to push in the opposite direction.
-The Washington Post