Here is a problem. You live in Mayfield Heights and your job is in Strongsville, about 30 miles away. Worse, you hate your old car, it is unreliable, gets terrible gas mileage, and needs expensive repairs. Do you
- Get a job closer to home?
- Get a better car?
- Put your car up on blocks, give away the tires, and hope that a new way to get to work will magically appear?
I have a lot of faith in my readers. I’m absolutely positive that almost all of you will choose some combination of options 1, 2, or 3.
Our health insurance system, an organized way for most of us to access and pay for health care, had a lot of problems twelve years ago. Some people thought that it was OK. Some thought that it wasn’t great, but major action wasn’t needed. But, a lot of Americans demanded significant improvements. A year’s worth of haggling, negotiations, and foot-dragging resulted in the Patient Protection and Affordable Care Act. President Barack Obama’s new book, A Promised Land, details the negotiations with Republicans such as Senators Chuck Grassley and Olympia Snowe. There were concessions made and amendments accepted, but in the end the legislation passed along party lines. The law was hardly perfect.
It has been eleven years since the law’s passage. The law was fully implemented January 1, 2014. Some of my clients were adversely impacted by the law, principally with higher pricing. Many more benefited from the elimination of medical underwriting, comprehensive benefits, and the Tax Credit Subsidies. Again, the law is hardly perfect and I certainly would have structured it differently, but the transition to life under Obamacare was infinitely smoother than the naysayers had predicted. There was, and still is, plenty of room for improvement.
How do you improve the PPACA? What would you do to make it better? For eleven years some people have had only one answer. Like the guy who disables his car to improve the way he gets to work, their answer was to repeal Obamacare without any viable replacement. Chest pounding, meaningless votes, and even a beer celebration with President Trump didn’t pay for a single doctor’s visit or hospital stay. The last four years featured the defunding of the Cost Share Reduction and untold stress for the millions of Americans with preexisting conditions.
The new administration has taken a much different approach. President Biden is trying to make the system work. We are in the middle of a Special Enrollment that has opened the process to purchase individual (non-group) coverage until August 15th. Over one million Americans have signed up since March 15th. The Tax Credit Subsidy has been updated to cover more people. And all of this is once again being publicized so that Americans will have a chance to improve their coverage. Perfect? Not yet. But this is a step in the right direction.
Your representatives in Washington may be Republicans or Democrats. Here is a quick experiment. If you ever see them in person again, ask them what, specifically they would do to improve Obamacare (Both sides call it that. It is not a pejorative.) Ask to see their plan. It has been eleven years. If they can’t answer the question by now, then your Congressman or Senator is no better than the guy at the beginning of this post who put his car up on blocks.
Picture – The Hard Way – David L Cunix