The President was bragging. The car radio, tuned to CNN, was playing President Trump’s press conference. Among his other claims of success, real or imagined, was his victory, yesterday, in the Supreme Court. He quickly corrected himself and changed it to the Appeals Court. He was talking about the Court of Appeals for the Fifth Circuit declaring the Individual Mandate provision of the Patient Protection and Affordable Care Act (Obamacare) unconstitutional. Mr. Trump was elated. He claimed that it was the Individual Mandate that made health insurance expensive.
Most of the people I know in this industry, from across the political spectrum, realize that the Individual Mandate could lower premiums by expanding the available pool of clients to include the youngest and healthiest amongst us. Since its origin from within the Heritage Foundation through the introduction of Clintoncare, Romneycare, and the creation of Medicare Part D (Rx) it has been widely accepted that plans that accept everyone (guaranteed issue) and that cover the most unhealthy (preexisting conditions) must be structured to incentivize participation by the entire eligible population. The Individual Mandate only became a Republican strawman when the PPACA neared passage in 2010.
This blog has discussed the Texas lawsuit, the effort by 18 states and the Trump administration to declare the PPACA unconstitutional, in numerous posts. We continue to cover it because the lawsuit’s success could eliminate coverage for nearly 54 million Americans with preexisting conditions and disrupt the way every one of us accesses and pays for health care. Yes, all of us. The elimination of Obamacare, its rules, its regulations, its heart, will impact individuals, employees covered by group health insurance, Medicare beneficiaries, and entire industries. Over and above health, and that should be enough, we are also discussing about 20% of our economy. But, I digress. Mr. Trump is elated.
The Department of Health and Human Services (HHS), the part of this administration in charge of implementing our system had nothing to say about this latest court decision. Here is the link to the department’s press releases of the last week. If the Texas lawsuit succeeded, the nation would turn to HHS for a solution. How would we cover preexisting conditions? How would our system react? As is so often in this administration, creating havoc is everyone’s job. Solving problems is no one’s.
One of the parties in the lawsuit is the Association of American Physicians and Surgeons. They aren’t just upset with Obamacare. The AAPS is still fighting the creation of Medicare! OY.
Though many legal scholars have derided the underlying legal argument at the heart of the Texas lawsuit, one would be foolish to rely on logic at a time like this. Senator Lamar Alexander (R-TN), was quoted in a Kaiser Health News article as saying, “I am not aware of a single senator who said they were voting to repeal Obamacare when they voted to eliminate the individual mandate penalty”. Yes, he was only trying to irreversibly damage the law. He didn’t mean to kill it! There are members of this administration that believe that dismantling the law would only impact residents in the 18 states pushing the lawsuit. As noted recently, H B 390 was just introduced in the Ohio House to address these issues. It is, at best, a start.
We just completed our annual Open Enrollment Period for individuals under age 65 and the Annual Enrollment Period for Medicare beneficiaries. In truth, I’m exhausted. But even more tiring is this struggle to make sure that Americans, at least the ones I impact, have health insurance, the way most of us access and pay for health care. Yesterday’s breaking news was that the federal government and a group of states are working hard to destroy our health care system without any idea what would happen if, G-d forbid, they succeeded.
Oh yeah, there was another major news story yesterday, but this is an insurance blog!
Picture – Broken! – David L Cunix