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[…]