The Facts About The Patient Protection and Affordable Care Act
The Patient Protection and Affordable Care Act reformed healthcare, and mandated minimum coverage for all healthcare plans. ACA forced insurers to cover pre-existing conditions, no caps, and free preventive care with no deductibles in all plans, both employer plans and through the exchanges. This included a wide range of services and procedures like yearly checkups, colonoscopies and caner screening for women. It also began the process of closing the Medicare donut hole for medication. Most importantly, it put the emphasis on preventive care, which has been shown to be much more cost effective long-term. Over time, this would have healthcare costs in the US down, and more in line with those in other developed countries.
Repeal of ACA means more out-of-pocket expenses, even for those on employer plans. Even if you are one of the few on a Cadillac employer plan that covers pre-existing condition and no caps, without ACA mandates, that only lasts while you keep your current job. The GOP and Trump lied when he said they would keep the good parts of Obamacare and get rid of the individual mandate. The pre-existing conditions and caps mandate cannot be covered without the ACA participation mandate.
The ACA does have problems that need to be fixed, and they could have been fixed. Instead, Republicans chose to try to sabotage it. Most republican-controlled states refused Medicaid expansion, because without it ACA does not work properly. Those were the states where there were big premium increases. In the states that accepted Medicaid expansion, the increase in premiums were much lowers than the average yearly increases before its implementation.
Now the GOP plan is for Trump to keep saying Obamacare will fail on its own in 2017, as they strip out key parts, causing it to fail, but avoiding the blame. In fact they started this process before the election, with a poison pill bill defunding the “risk corridor,” deliberately creating the rate increases they then attacked.
The GOP have no plan, because ACA was based on the republican plan first proposed by the conservative Heritage Foundation who first proposed the individual mandate adopted by Romney in Massachusetts. They only abandoned it when it was adopted by President Obama as a blueprint for ACA. Basically, are now trying to come up with a stripped down version of Obamacare, with a fixed tax credit for everyone, with little or no mandated coverage. This will allow healthcare insurance companies to go back to providing substandard policies at high prices, with unlimited profits. That is why the insurance companies have been playing their part in the GOP sabotage efforts.
Healthcare insurers are playing their part in the sabotage too. They would like to go back to the days before ACA when they could sell garbage plans that offered little coverage and substantial profit margins. Last summer Aetna claimed it was pulling out of all but four of the 15 states where it was participating in the exchanges. They claimed it was a business decision. They were simply losing too much money on the ACA exchanges. Last month a court found that to be a lie. The federal judge ruled that Aetna made its decision in response to a federal antitrust lawsuit blocking its proposed $34-billion merger with Humana. Aetna had threatened federal officials with the pullout before the lawsuit was filed, and followed through on its threat once it was filed.