Six and a half years after the ACA was signed into law, health reform no longer feels like a steady forward march toward progress. It feels more like World War I: dotted with landmines, lined with trenches, and ending inconclusively. In 2010, the Congressional Budget Office predicted that 21 million people would be enrolled in the ACA’s insurance exchanges by 2016; as of now, only 12 million are. That gap between hype and reality is likely to further expand over time.
What happened? It’s a long story, of course. But the simple answer is that the ACA’s exchanges were designed poorly and implemented poorly, by overconfident advocates who dismissed any and all criticism, no matter how well-reasoned.
. . .
Donald Trump and Hillary Clinton sparred over Obamacare during the second presidential debate on Sunday, outlining how they would reform the health insurance system.
“Obamacare is a disaster,” Trump said. “You know it, we all know it.”
The candidates responded to a question on how they would bring down the costs of healthcare which surged after the Affordable Care Act was passed.
Americans are paying more out of pocket for their medical care than ever before, partially because of the rise of high-deductible plans . Also, the percentage of Americans’ income spent on healthcare is increasing.
. . .
Last week, the comptroller general — the government’s chief accountability officer — issued an official statement that the administration has been sending unlawful payments to insurance companies through the ACA’s reinsurance program. These payments have totaled $3 billion thus far and have forced taxpayers to finance a larger part of insurers’ most expensive enrollees’ claims.
The U.S. House of Representatives filed suit against the administration for unlawful payments through another ACA program. These payments are to insurers for them to make plans more attractive by reducing enrollees’ deductibles and cost-sharing amounts. Congress never appropriated funds, yet the administration has paid insurers at least $10 billion through this program thus far.
. . .
The Obama administration is worried that insurers bailing out of the health law’s markets may prompt their customers to drop out, too. So it plans to match affected consumers with remaining insurance companies.
The hope is to keep people covered, but there’s concern that the government’s match-making will create confusion and even some disappointed customers.
. . .
While health plans struggle to make profits off individuals buying commercial coverage on public exchanges under the Affordable Care Act, the insurance industry still sees promise in the law’s Medicaid expansion.
Take Wellcare Health Plans’ announcement that it has signed a deal to buy the Arizona operations of Care1st Health for $157.5 million in a deal that will add 114,000 Medicare and Medicaid beneficiaries in the state’s largest market, Maricopa and Pima counties.
. . .
Tennessee is ground zero for ObamaCare’s nationwide implosion. Late last month the state insurance commissioner, Julie Mix McPeak, approved premium increases of up to 62% in a bid to save the exchange set up under the Affordable Care Act. “I would characterize the exchange market in Tennessee as very near collapse,” she said.
Then last week BlueCross BlueShield of Tennessee announced it would leave three of the state’s largest exchange markets—Nashville, Memphis and Knoxville.
. . .
Republicans in Congress are plotting ways to block the Obama administration from paying insurance companies hundreds of millions of dollars as part of an ObamaCare program.
GOP lawmakers say they are looking at “a dozen” options — including a possible provision in the year-end spending bill — to prevent the administration from using an obscure fund within the Treasury Department to pay out massive settlements to insurers.
. . .
Proponents of the Affordable Care Act made several promises before and since the law passed. The most notorious of these was President Barack Obama’s assurance that people could keep their insurance plan if they liked it. However, other important promises were made that have garnered less media coverage, including how many people would enroll for coverage in the new health insurance exchanges, the law’s effect on health insurance premiums, the amount of choice and competition in health insurance markets, and the law’s impact on overall costs and the deficit. These promises arguably helped ensure some of the votes necessary for the controversial legislation to pass Congress.
. . .
States with some of the worst Obamacare news this year also have the biggest need for people to sign up, presenting a major challenge to advocates for the healthcare law.
Of the six states where insurers have proposed the steepest price increases affecting the most people, five have among the highest uninsured rates in the country, according to data compiled by independent analyst Charles Gaba.
In Tennessee, where 11 percent of residents remain uninsured, average monthly premiums could rise by 56 percent next year if insurers follow through with the prices they have proposed.
. . .