The US Health (insurance) Crisis

With the constant on again off again parade of GOP health care bills, Executive Orders, bipartisan Affordable Care Act (ACA) rescue bills, administrative rules changes and directives, we have a full-blown mess on the health insurance landscape. FUBAR would be an apt description. Which makes the situation far worse is that we are in the open enrollment period for most insurance plans. Now is the time people should be making their decisions about which company to go with, which plan to choose, which deduction and co-pay levels, etc. How can the insurance companies offer stable policies or individuals choose a plan when the rules keep changing? Even if Congress or the administration reach some sort of agreement for 2018 health care, there is no way to know what is in store down the road. In fact, there is no guarantee that Trump won't get out his magic pen in a couple of months and undo anything agreed to this year. 

Is it any wonder that insurance providers are abandoning the ACA marketplace? Businesses shouldn't be guaranteed a profit, but they should be able to know the rules of the game. 

It's a well-known fact that the Republican party has campaigned against the ACA since its passage in 2010. Repeal & Replace was their mantra. While I don't agree with that, it is their right to craft their platform however they want. In 2017, the GOP took control of the Congress and the White House. They did not need one single Democratic vote in either House to pass legislation. Had they been able to pass a health care bill early in the year, everyone would know what to expect for the next few years. Once it became apparent, over and over again, that they couldn't agree, they owed it to the consumers and the providers to extend and fund the ACA for at least one year. 

On top of the GOP congressional failure, we have Trump and his administration doing everything possible to sabotage the ACA. They have reduced the signup period, drastically reduced advertising dollars and promotion, and all but eliminated the ACA from any mention on government websites. Then, via Executive Order, Trump eliminated some coverage mandates and subsidies that help people afford deductibles and co-pays among other changes. Those subsidies were eliminated immediately so it also affects 2017 policyholders. A draconian measure by Trump and a broken promise by our government. 

Why has all this happened? Well, the GOP is a fractured party. Some in the Senators voted against the various replacement plans because millions would lose affordable coverage. Others voted against the bills because they didn't go far enough in eliminating government assistance or regulations. As for Trump's administrative directives and Executive Orders, he will do anything and everything possible to eliminate any trace of the Obama administration. It is personal with him, the consequences be damned. 

The result of all this will be a reduction of the number of people covered, an increase in premiums, and a reduction of coverage. It will be the ordinary citizens who suffer, many of whom are or were Trump supporters. The President, members of Congress, the rich, and big insurance companies won't suffer. The fat cats rarely do.

Some of us have Medicare or employer-provided insurance and are not directly affected by the current health care SNAFU, yet. The latest GOP House budget bill may change that. It includes Medicare and Medicaid cuts. Just hope that you don't find yourself out of work or that your employer decides to drop health insurance coverage. That will be much easier in the future. The Republicans also have their sights on Medicare and Medicaid. They are always looking for ways to reduce social programs so they can funnel the money to business and the rich. 

The ACA wasn't perfect to begin with and is now a gutted and much worse program. It was a beginning to a more humane and equitable way to improve the health of our nation. We have now taken a giant step backward, probably with more steps in the wrong direction to come.

Be careful what you wish for. The Republicans and Trump now own health care. Let's see how you like it now.

wjh