Simple Fix for Obamacare

Given the announced increases in Obamacare premiums it’s important that people have accurate information about what it means and how you may be affected. I found this article in the New York Times and it’s certainly worth your time. Pay special attention to the roll a “functioning” Congress needs to play in the fix.

Figuring out how Obamacare is faring has always been hard.
It’s been hard because many Republicans are rooting for the law to fail and try to make any flaw sound existential. And it’s been hard because we in the media haven’t always done a good job covering the law. We tend to sensationalize its problems, rather than distinguishing between routine ones and truly worrisome ones.
The recent spike in premiums — raising the cost of many insurance plans — is a real problem. But it’s also contained to the smaller part of Obamacare’s coverage expansion, and it’s a problem that could be easily solved by a functioning Congress.
First, some context: The 260 million or so Americans who receive health insurance through their employer, Medicare or Medicaid (including through Obamacare’s Medicaid expansion) are unaffected by the prices increases. The increases instead apply to the 10 million people who buy coverage on one of the private-insurance exchanges established by the law. Even among those 10 million, the vast majority receives government subsidies that will largely or partly cancel out the price increase.
So why do I say the price increases are a real problem? Because those insurance exchanges are vital to the idea of universal coverage in this country. Without them, many people who don’t qualify for government insurance or aren’t covered through their job will be stuck without good medical care.
The spike in premiums is a sign that not enough healthy people are signing up for the exchanges. Without healthy people to balance out the sick, insurance stops being insurance and becomes terribly expensive.
The basic solution is straightforward. It involves increasing the subsidies for lower-income families — while also increasing the penalties for people who refuse to sign up for health insurance. The overall cost of this fix would be modest, and a better functioning Republican Party would have no problem agreeing to a compromise. It would preserve a robust role for the private market, after all.
The more boldly liberal solution is to create a so-called public option on the exchanges — a government insurance plan anyone could buy. In a Times Op-Edtoday, Jacob Hacker — one of the architects of the public option — makes the case for it.
I’ll confess to being torn about whether the public option is a more complex solution than the current problem requires. I encourage you to read Hacker’s piece – and also this recent Times piece raising questions about the public option. If you have thoughts after doing so, send me an email, at Leonhardt@nytimes.com.
David Leonhardt
Op-Ed Columnist

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