Editorial: Affordable Care debate not over yet

  • Posted: Thursday, April 10, 2014 6:13 a.m.

President Barack Obama’s boast probably was premature. “The debate about repealing this law is over,” he said. “The Affordable Care Act is here to stay.”

For more than 7 million Americans who signed up, the ACA is now something they’re counting on for medical coverage. That does not mean the political debate is over. Far from it.

U.S. Sen. Richard Burr of North Carolina entered the conversation earlier this year when he and fellow Republicans Orrin Hatch of Utah and Tom Coburn of Oklahoma introduced what they call the Patient CARE Act. Their goal is to, first, repeal Obamacare and, second, to enact their alternative.

Their plan promises popular features: It makes sure patients with pre-existing conditions can get coverage. It does away with lifetime limits. It lets young adults stay on their parents’ plans until age 26. It offers government assistance so coverage is more affordable for people with modest incomes. All borrowed from Obamacare.

In other respects, it’s vastly different. It doesn’t require Americans to purchase medical insurance but instead relies on incentives in the form of tax credits and also protection from being denied coverage for pre-existing conditions — but only if they sign up during specified open enrollment periods. That means, if they don’t sign up, those with pre-existing conditions might never get coverage.

People who qualify for a tax credit but don’t sign up would be subject to “default enrollment.” They would be placed in a plan unless they opted out.

Patients with costly medical conditions would be covered through state-run high-risk pools, assisted by “targeted federal funding” to avoid passing a share of those costs directly to other individuals. At the same time, expanded Medicaid coverage — which North Carolina declined to implement — would be rescinded. Patients eligible for Medicaid could choose to enroll in private plans with tax credits.

Consumers could obtain less-expensive policies because insurance companies would not be required to offer as much coverage as the ACA requires. Younger people would save even more because older consumers could be charged up to five times as much for their coverage, as opposed to three times as much under the ACA.

So, where was this plan in 2009 when the Senate was crafting the health care legislation? Maybe a better Affordable Care Act would have emerged from Congress with bipartisan backing and a commitment by leaders from both parties to make it work for the benefit of the American people. Instead, Republicans have spent years calling for repeal without offering viable ideas to provide health care security to millions of Americans.

Still, it may not too late for both parties to work together to mend the ACA’s flaws. Such efforts should begin with a pledge not to dump Americans from the coverage they’ve selected and might like.

— News and Record


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