Resting on their “tax reform” laurels, the lethargic Republican majority in Congress seems content to take a summer snooze rather than work to enact the policies they promised the public.
The increasingly strident rhetoric in favor of universal health care preached by the likes of Senator Bernie Sanders and the left’s new darling Alexandria Ocasio-Cortez has been met with shrugs from their erstwhile opponents in the GOP.
And that’s worrying, because Obamacare has been failing in a fantastic way, and without action from Congress these voices will be the only offering solutions.
Trump has made a political calculation to gut Obamacare by slowly chipping away at it—which makes a lot of sense, given Congress’s lack of action. One way his administration has done this is by allowing states to lengthen the time that people can remain on short-term health insurance plans. Yet while this appeal to federalism is admirable, it would be a mistake for states to take it up.
The real solution is that Obamacare needs to be repealed and Congress needs to pass an actual comprehensive solution—period.
Here’s why: premiums increased 21 percent from 2016 to 2017, while average monthly enrollments in individual market plans decreased 10 percent, according to a chilling new Centers for Medicare and Medicaid Studies (CMS) report. Only six states had an increase in unsubsidized enrollees over this period, and all were single-digit increases. Most of the “alarming” decrease in enrollment occurred in the unsubsidized portion of the market, while the subsidized portion was 61 percent larger than the unsubsidized portion in 2017, up from 23 percent larger in 2014. This occurred before Trump’s changes to the Obamacare marketplace.
“The unsubsidized portion of some state individual markets have clearly entered a death spiral, with unsubsidized enrollment dropping by more than a third in 14 states, including an astonishing 73 percent decline in Arizona,” the CMS report notes.
While executive orders signed by Trump in 2017 expanded insurance sales across state lines and ended insurer subsidies, chipping away at Obamacare with small changes to short-term insurance options simply won’t cut the mustard.
There are two groups of people who would likely sign up for an extension of short-term insurance. The young and healthy will calculate correctly that this is a better alternative for them, leaving in the remaining Obamacare mostly older, sick people, and thus making that pool even more expensive. The other group who will take the “lower sticker price” of short-term insurance are those who misunderstand what is actually covered by those plans. By the time they need health care and are hit with the extremely high premiums attached to those plans, they’ll likely be pushed onto the federal rolls, or become part of another sad statistic: medical bills are the leading cause of U.S. bankruptcies, according to CNBC.
“Even outside of bankruptcy, about 56 million adults—more than 20 percent of the population between the ages of 19 and 64—will still struggle with health-care-related bills this year,” according to the CNBC report, citing NerdWallet Health.
The Democrats led by House Leader Nancy Pelosi and Senate Majority Leader Harry Reid pushed through Obamacare when they held power. Back in those heady days of opposition, the GOP promised to pull out the health law “root and branch.” Now, congressional Republicans are either too cowardly to fight or have acknowledged that the “root and branch” stuff was just a disingenuous promise to win back power. They’ve been silent as the grave on health care since their failed attempt to pass the American Health Care Act last summer.
Yet for most Americans, the inability to afford health insurance is a very real and very frightening prospect. Forty-seven percent of the public would have to borrow or sell something just to cover a $400 emergency. It goes without saying that they are unable to afford massive rate hikes, yet Obamacare premiums have skyrocketed year after year. In states like Idaho, West Virginia, South Carolina, Iowa, and Wyoming, rate hikes averaged 30 percent or higher in 2017. Combine our ballooning national debt and the increasingly large portion of the federal budget dedicated to health care, and it is clear that something must be done. Total national health care spending reached $3.3 trillion or $10,348 per person and 17.9 percent of gross domestic product in 2016.
Obamacare was implemented mainly through executive fiat and a mountain of red tape totaling over 20,202 pages. Its restrictions were disruptive and destructive. With the 2018 reckoning almost upon us and Americans facing fewer and fewer affordable options, the pressure is on Congress to act. They cannot and should not rely on executive orders from Trump to fix this mess. Their job is to legislate and they are not doing it.
Barbara Boland is the former weekend editor of the Washington Examiner. Her work has been featured on Fox News, the Drudge Report, HotAir.com, RealClearDefense, RealClearPolitics, and elsewhere. She’s the author of Patton Uncovered, a book about General Patton in World War II. Follow her on Twitter @BBatDC.