By now it’s probably not surprising to anyone to hear that the House voted – yet again – to repeal the ACA yesterday. This is the 37th time in the last three years that they’ve voted to repeal and/or defund all or part of the law. They are fully aware of the fact that their vote will – as usual – end with them, as it’s highly unlikely to get through the Senate. But they continue to focus a rather significant portion of their (taxpayer funded) time on this issue.
It’s understandable that there are objections to the ACA. To say otherwise is to be blind to some of the obvious problems that are inherent in the law. We’ve written numerous posts in support of the ACA over the past few years, but we’ve also noted several concerns that we have, and I think they’re valid ones. Premiums in the individual market might end up being higher after full ACA implementation for a lot of people who receive little or no subsidies (we’re expecting to see rates published by the end of this month for policies that will be sold in the Colorado health insurance exchange. The deadline for carriers to file them was Wednesday). New restrictions on age-banded rate ratios might end up making younger, healthier people (the ones who are most needed in the health insurance pool in order to stabilize premiums for older, sicker insureds) less likely to obtain coverage. This problem might be exacerbated by a less-than-robust individual mandate, at least for the next year or two. We’ve also wondered whether the exchanges will be capable of providing a high level of customer service, given the complexity of the enrollment process (assuming an applicant qualifies for subsidies) and the fact that many of the applicants will be applying for health insurance for the first time. Will the exchanges have enough staff to rise to the customer service level provided by private industry, or will contacting a knowledgeable representative during the open enrollment period be on a par with getting a hold of a knowledgeable representative at the IRS between January and April?
The concerns that we have about the ACA are outweighed by the positives though: More people with health insurance, guaranteed issue individual plans, better preventive care, and numerous provisions that will attempt to curb costs (although how effective they will be remains to be seen) – among many others. But we understand that the opposite is true for many Americans. A good chunk of the population is more worried than optimistic when it comes to the ACA. They may be people who haven’t yet been directly impacted by the law (or might not be aware that they have been impacted). Their concerns might be valid or they might have been unduly influenced by spin techniques that have little basis in reality (there are no death panels in the ACA!) But either way, it’s understandable that there is still significant resistance to the ACA. And among the Republican-dominated House, those concerns have manifested themselves many times over the last few years.
That’s acceptable. I have no problem with a group of politicians “wasting time” by voting on an issue despite knowing that their measure won’t ultimately succeed. I would hate to think that politicians would just give up on issues that I agree with, just because they have little hope of their bill eventually being signed into law. What I DO have a problem with is that the House Republicans seem to be more concerned with repealing and/or defunding the ACA than they are with coming up with effective solutions to take its place. In House Speaker Boehner’s weekly address (around the 4:50 mark in the video), he seems very unconcerned with specifics in terms of what he thinks should be done, and there doesn’t seem to be a lot of urgency on his part to make changes to our healthcare system. We all know that he things the ACA isn’t the solution. But what is the solution? We’ve all heard the ideas about tort reform, buying health insurance policies across state lines (perhaps not such a good idea, at least under current regulations), and enhancing HSAs. These are some of the ideas that Republican lawmakers have put forth. I’m sure that the first item on that list, “lowering health care premiums” is a popular one… I’m just not entirely clear about how they plan to do that. Remember, that was a big promise with the ACA, and we don’t know yet whether it will ultimately be the case or not.
Healthcare is unfortunately a luxury for a lot of Americans. It shouldn’t be that way. Everyone needs access to quality healthcare at a price that they can afford – without having to choose between going to the doctor or putting food on the table. I’m the first to admit that the ACA has its flaws. And I’m sure we’ll see plenty of hiccups over the next year as more provisions of the law are implemented. I can understand citizens and lawmakers being concerned and wanting to address the problems that they see in the law. But we cannot simply keep things the way they were prior to the ACA being signed into law. I doubt that the House is finished with their efforts to derail the ACA, and that’s ok – it’s their job to try to implement laws that represent their constituents’ needs and desires, and a good chunk of the country is not convinced that the ACA is the right way to go. But before they push for another vote to repeal or defund all or part of the ACA, I’d like to see them put forth very specific recommendations for change, including details on exactly how their solutions would work to make sure that everyone in America has access to quality, affordable healthcare.