The Senate voted to repeal the Affordable Care Act and defund Planned Parenthood Thursday evening, clearing a nearly six-year hurdle that kept previous attempts to undo the health care law from reaching President Obama’s desk. Though the president has vowed to veto the bill, it passed 52-47. The legislation would repeal major parts of the president’s signature policy achievement, including the individual and employer mandates and Medicaid expansion, which would be aborted after a two-year delay.
A narrow majority of physicians say Obamacare has a negative impact on medical practice, including on the quality and cost of health care, according to a report from the Journal of the American Medical Association. The report found that 52 percent of physicians look on Obamacare as unfavorable to the general medical situation, while 48 percent say it is favorable.
The latest turmoil in health insurance marketplaces created by the Affordable Care Act has emboldened both conservatives who want to shrink the federal role and liberals who want to expand it. UnitedHealth Group announced last week that it may pull out of the marketplaces in 2017 after losing money this year. This followed the collapse of 12 of the 23 nonprofit insurance cooperatives created with federal loans under the health law. In addition, insurance markets in many states are unstable. Premiums are volatile and insurers say their new customers have been sicker than expected.
Philip Dorsey, a retired lawyer and legal editor, recounts his experience with health insurance since the Affordable Care Act was enacted. Mr. Dorsey has been forced out of his plan each New Year’s Day since 2012.
“In the first year I got a glimpse of how reform reduced coverage for the many on the group health plans offered by large corporations to their employees. In the second year I saw how it had similar effects on the owners and employees in small businesses that obtain group plans through professional or trade associations. In the third year I would see how individuals who lost group insurance coverage were affected when forced into the individual market.”
The future of the Affordable Care Act could depend on the success of federal and state administrators in signing people up in the current open enrollment period—the last one before the 2016 election. Over 10 million people eligible for ACA coverage have yet to sign up. Retention of those already covered may be hindered by rising premiums, dissatisfaction with high deductibles or coinsurance in some plans, limited choices of providers offered by plans, or simple ignorance of the necessity to re-enroll.
A new survey by Gallup shows growing discontent with ObamaCare and the U.S. health care industry generally after years of relative satisfaction with the quality and cost of the health-care system. 53% of Americans rate health care quality in U.S. positively, 1 in 3 rate U.S. health care coverage positively, and fewer than 1 in 4 are satisfied with the cost of health care.
Gallup’s latest poll shows the majority of Americans still oppose the ACA, even two years after its full implementation. Those who are uninsured oppose the health care law by nearly 30 points.
When President Obama’s landmark health care law ushered in a slew of new insurance options in 2013, the Andersons could not wait to sign up. But in April, when Roger Anderson fell while hiking and hurt his shoulder, he discovered, to his dismay, that simply being insured was not enough. The Andersons’ mid-tier health care plan costs them $875 a month and requires them to meet a $7,000 deductible before insurance payments kick in. Their experience echoes that of hundreds of thousands of newly insured Americans facing sticker shock over out-of-pocket costs.
The Obama administration officials are touting low premiums available during open enrollment on Healthcare.gov, but for many new patients receiving coverage under the ObamaCare exchanges, the sticker shock of sky-high deductibles leaves them just as vulnerable as before they were covered. The New York Times found that in many states, more than half the insurance plans offered on the federal exchanges had deductibles of $3,000 or more.
For the press, the debate over ObamaCare is over. There may be a few proverbial Japanese soldiers wandering on isolated islands yammering on about the failure of ObamaCare, but word will eventually filter down to them, too. This assumption is so deeply embedded that it is impervious to new evidence that ObamaCare is an unwieldy contraption that is sputtering badly. Yes, ObamaCare has covered more people and has especially benefited those with pre-existing conditions (to be credible, Republican replacement plans have to do these things, as well), but the program is so poorly designed that, surely, even a new Democratic president will want to revisit it to try to make it more workable.