I like Obamacare, as the Affordable Care Act (ACA) of 2010 is popularly called. Health care should be accessible and affordable for all. The ACA is not as universal in its reach as Social Security and Medicare, but it certainly goes a long way toward achieving the goal of protecting all of us from the fear of not being able to provide health care for our family members if they become ill. It’s not perfect – it doesn’t do as much as will ultimately be necessary to bend the growing cost curve down, and it does not reach absolutely everyone – but it is far superior to what has gone before. Which is what we will return to if Linda McMahon and her Republican compatriots succeed in their campaign to “repeal Obamacare,” as her new advertising promises to do.
Repeal Obamacare? Twenty thousand young adults in Connecticut would lose the health care insurance coverage they’ve been able to obtain under the ACA’s provision that they be covered under their parents’ policies until they reach age 26. So why does McMahon demand repeal?
Repeal Obamacare? More than 700,000 men, women and children in Connecticut would no longer have coverage for age- and gender-appropriate preventive services like vaccinations, annual wellness visits, colon cancer screenings, and mammograms without cost sharing (co-pays, deductibles or co-insurance). So why does McMahon demand repeal?
Repeal Obamacare? Nearly 1,400,000 Connecticut residents no longer have a lifetime limit on their health insurance plan because of the ACA’s provisions; in 2014, annual limits will also be prohibited. Insurers could re-institute these caps if Obamacare is repealed. So why does McMahon demand repeal?
Repeal Obamacare? If you were the parent of one of the 163 children in Connecticut who has been able to gain coverage despite the existence of a pre-existing condition, you would be eternally grateful that the ACA guaranteed that your child was not turned away. And in 2014, adults will gain that same “guaranteed issue” protection if Obamacare remains in effect. So why does McMahon demand repeal?
Repeal Obamacare? Already over 56,000 Connecticut Medicare recipients on Medicare Part D (prescription drug coverage) have saved an average of $653 each because Obamacare is gradually closing the “donut hole” – the coverage gap – that will disappear by 2020 if Obamacare is not repealed. Those recipients in the “donut hole” are now paying only 50% of the cost of brand name drugs, down from 100% before. Why don’t you tell your mother what Linda McMahon is proposing? So why does McMahon demand repeal?
Repeal Obamacare? Then insurance companies can go back to their old practice of rescinding coverage and denying payment for services if they discover an error or technical mistake on an application. So why does McMahon demand repeal?
Repeal Obamacare? Persons who retire without employer-sponsored insurance, and before they are eligible for Medicare, have often seen their life savings eroded because of high rates on individual policies.The ACA already is providing some assistance to preserve employer coverage for these early retirees, and in 2014, more affordable coverage will become available – again if Obamacare is not repealed. So why does McMahon demand repeal?
Repeal Obamacare? Then insurance companies will no longer be required give rebates to customers if the companies don’t spend at least 80% (for individual and small employer plans) or at least 85% (for large employer plans) of all premium dollars on health care services and health quality improvements. So no more rebates to you – in Connecticut, rebates totaling more than $12 million are anticipated this August – if your insurance company directs more of your premium dollar to administrative costs and profits. So why does McMahon demand repeal?
Repeal Obamacare? In 2014, the ACA eliminates the ability of insurance companies in the individual and small group market to charge higher rates due to gender or health status. So if Obamacare is repealed, insurance companies can continue the current practice of charging women higher rates than men, and charging sick people higher premiums. So why does McMahon demand repeal?
Repeal Obamacare? The ACA expands Medicaid after 2014, by making available payments to providers who give medical care to all persons with incomes less than 133% of poverty, not just low-income senior citizens who need nursing home care, persons with disabilities who cannot afford care, and low-income children and their parents. This massive expansion of Medicaid to new recipients will be paid for 100% by the national government for three years (2014-2016), phasing down to 90% by 2020. The Supreme Court has decided that the ACA cannot require states to accept this paid-for expansion, but the benefit remains available to all states which voluntarily agree to take it. [And they should do so, both to benefit these low-income adults, and to assist hospitals and other health care providers who will receive payment, however low, for services for which they are currently uncompensated.] Fortunately, Governor Malloy and the General Assembly have acted to prepare Connecticut to be a volunteer. The assistance, however, goes away if Obamacare is repealed. So why does McMahon demand repeal?
Repeal Obamacare? If you want health care insurance, but can’t afford it, the ACA provides substantial tax credits and other cost-sharing assistance to individuals and families with income less than 400% of the federal poverty level (about $90,000 for a family of four). The tax credits are both advanceable (paid to insurance companies up front, so that a recipient doesn’t need to pay it and wait for reimbursement) and refundable (if you don’t owe as much income tax as the credit is worth, you get the excess refunded). These subsidies to help people buy health insurance are substantial: the Congressional Budget Office estimated in March 2012 that the average subsidy per recipient will be about $4,800 in 2014, increasing to more than $7,000 in 2022. There will be no credits and no cost-sharing assistance, however, in the absence of Obamacare. So why does McMahon demand repeal?
Given all of these benefits for Connecticut voters that will be lost if Obamacare goes away, why does McMahon demand repeal?
Bill Cibes is a former professor of government at Connecticut College and former chancellor of the Connecticut State University System. He formerly served as Secretary of the Office of Policy and Management in the administration of Governor Lowell P. Weicker.