Actually for many it was repealed... the Tax Reform Bill signed into law also effectively repeals the Obamacare individual mandate that forces Americans to buy health insurance or pay a tax penalty.
The only practical test for any legislation affecting health care is whether or not it expands availability by making care costs more affordable. The ACA made a shallow step in that direction by bolstering the funding pool through mandatory enrollment. I say "shallow," because despite supporting a DIY parallel option (Health Insurance Exchanges) and expanding Medicaid, it essentially enrolled more people in for-profit insurance plans. The Tax Reform Bill does nothing to make health care more affordable. It does the opposite. It shrinks the revenue pool by removing the mandate and portends drastic cuts to federal health care offsets (Medicaid, Medicare, SSI) as deficits balloon due to revenue shortfalls. Additionally, the CBO forecasts that 13 million Americans will likely drop health insurance once the mandate goes away in 2019. The impact of that revenue void will drive up health care costs due to the combined effect of revenue loss, unpaid care bills and insurance companies foregoing individual plan offerings. Insurance companies recognize that if healthy individuals drop out, individual plan enrollment will be largely comprised of sick people- IE: those who draw on the pool as opposed to enriching the pool. The nation has already lost 20% of its providers willing to sustain the individual plan market. 2019 will likely see more insurance companies dropping that option. As much as I would prefer to see a single-payer system in this country (which the ACA is/was not) I can't see anything good about the dismantling of the ACA- even if the deadbeats enjoy the respite from losing the mandate. I say "deadbeats," because even the most oblivious of them must understand that it's a 'pay me now or pay me later' scenario.
Another reason dropping the mandate will drive up health insurance costs (with a likely spill over into employer plans) is that the ACA's requirement that insurance companies cover pre-existing conditions means healthy people have another incentive to drop coverage knowing that if they get sick, they can re-enroll with no penalty and have that pre-existing condition covered.
So, again, non-employer provided insurance is going to be something only people who have conditions are going to carry making coverage more expensive for those people.
That will have a spillover effect the rest of society.
The ACA was a conservative Republican plan, including the individual mandate. They only demonized it after Obama adopted it as his policy of choice for dealing with out of control healthcare costs. They cried "repeal and replace," but had no plan for replace. And of course, they couldn't find a more conservative plan than the ACA because the ACA is a VERY CONSERVATIVE approach to making health insurance affordable, especially when compared to single payer, which is why the Republicans came up with the idea -- to forestall single payer.
Now they sabotage their own plan -- remove cost-sharing reductions, end the individual mandate, refuse to promote the enrollment period.
The sad irony is that most of the people who complain about the ACA were entirely unaffected by it. Most Americans have employer-provided health insurance plans. This should have been a complete non-issue to them.
But over the next couple of days, many of them will be sitting down to Christmas dinners and chances are they will be at the table with a family member or two who desperately need or want affordable health care coverage, the health care coverage they've encouraged their representatives to sabotage. I'd like to see them explain that to their loved ones: "I've got mine, so screw you."
For the record, the ACA has saved Billie and me tens of thousands of dollars in medical expenses over the past four years. Without it, The Batavian wouldn't exist today.
Actually for many it was
Actually for many it was repealed... the Tax Reform Bill signed into law also effectively repeals the Obamacare individual mandate that forces Americans to buy health insurance or pay a tax penalty.
That's just one provision of
That's just one provision of an 800-page bill. The marketplaces still exist. Subsidies for low-income uninsured still exist.
Time will tell if ending the individual mandate, which was part of the original GOP bill submitted during Bill Clinton's presidency, has any impact.
The only practical test for
The only practical test for any legislation affecting health care is whether or not it expands availability by making care costs more affordable. The ACA made a shallow step in that direction by bolstering the funding pool through mandatory enrollment. I say "shallow," because despite supporting a DIY parallel option (Health Insurance Exchanges) and expanding Medicaid, it essentially enrolled more people in for-profit insurance plans. The Tax Reform Bill does nothing to make health care more affordable. It does the opposite. It shrinks the revenue pool by removing the mandate and portends drastic cuts to federal health care offsets (Medicaid, Medicare, SSI) as deficits balloon due to revenue shortfalls. Additionally, the CBO forecasts that 13 million Americans will likely drop health insurance once the mandate goes away in 2019. The impact of that revenue void will drive up health care costs due to the combined effect of revenue loss, unpaid care bills and insurance companies foregoing individual plan offerings. Insurance companies recognize that if healthy individuals drop out, individual plan enrollment will be largely comprised of sick people- IE: those who draw on the pool as opposed to enriching the pool. The nation has already lost 20% of its providers willing to sustain the individual plan market. 2019 will likely see more insurance companies dropping that option. As much as I would prefer to see a single-payer system in this country (which the ACA is/was not) I can't see anything good about the dismantling of the ACA- even if the deadbeats enjoy the respite from losing the mandate. I say "deadbeats," because even the most oblivious of them must understand that it's a 'pay me now or pay me later' scenario.
Another reason dropping the
Another reason dropping the mandate will drive up health insurance costs (with a likely spill over into employer plans) is that the ACA's requirement that insurance companies cover pre-existing conditions means healthy people have another incentive to drop coverage knowing that if they get sick, they can re-enroll with no penalty and have that pre-existing condition covered.
So, again, non-employer provided insurance is going to be something only people who have conditions are going to carry making coverage more expensive for those people.
That will have a spillover effect the rest of society.
The ACA was a conservative Republican plan, including the individual mandate. They only demonized it after Obama adopted it as his policy of choice for dealing with out of control healthcare costs. They cried "repeal and replace," but had no plan for replace. And of course, they couldn't find a more conservative plan than the ACA because the ACA is a VERY CONSERVATIVE approach to making health insurance affordable, especially when compared to single payer, which is why the Republicans came up with the idea -- to forestall single payer.
Now they sabotage their own plan -- remove cost-sharing reductions, end the individual mandate, refuse to promote the enrollment period.
The sad irony is that most of the people who complain about the ACA were entirely unaffected by it. Most Americans have employer-provided health insurance plans. This should have been a complete non-issue to them.
But over the next couple of days, many of them will be sitting down to Christmas dinners and chances are they will be at the table with a family member or two who desperately need or want affordable health care coverage, the health care coverage they've encouraged their representatives to sabotage. I'd like to see them explain that to their loved ones: "I've got mine, so screw you."
For the record, the ACA has saved Billie and me tens of thousands of dollars in medical expenses over the past four years. Without it, The Batavian wouldn't exist today.