As someone who desperately wants the Affordable Care Act to work, I’ve been tough on the failure to launch the health care exchanges necessary to make it do so.
Maybe I’ve been too tough.
My father-in-law — who spent his career building software that often had to map into federal government regulatory schemes — told me last night that this launch is about “average.” For the unprecedented scope and complexity of the necessary systems and general glitchiness that comes with any launch, he thinks the rollout of Healthcare.gov and the state exchanges is about what should have been expected. For that reason it probably have launched at least three months earlier so the future of the law wasn’t depending on making the sites work well in the next few weeks.
Regardless, until all the sites work, it’s going to be impossible to convince people, even the people who don’t think President Obama is Satan, that this law is a very good thing for America. Still, we should try.
Here are five things everyone should know about Obamacare now:
1. It’s already reducing America’s health care costs.
Paying more for health care than any country in the industrialized world to still have the highest uninsured population is expensive and detrimental to our economy. Our long term deficit problem is basically the result of us overpaying for health care. Medicare Part D, which wasn’t funded at all, made that problem worse. Obamacare is making it better: health care costs are growing at the slowest rate since we started recording them. This has robbed conservatives of the urgency to make brutal cuts to our meager but essential safety net.
2. It ends the discrimination against the sick.
Vulnerability illness and injury is the one thing all humans have in common. Our health care system punishes the sick and does it in a way that makes care more expensive for the healthy when we have to care for the very ill as they show up in emergency rooms. For the millions of Americans — like our Amy Lynn Smith who suffers from a chronic illness — this will be life-changing and possibly life-saving.
3. Insured people will mostly pay the same or less than they pay now; millions will pay nothing to insurance companies.
It’s true that about 4 million people will have to pay more for the coverage that they currently have. They’re healthy people who earn over 400% of the poverty rate. Another 10 million of the currently insured will pay the same or less as they currently pay. An estimated 7 million young people are eligible for completely subsidized coverage. Millions more are qualified for Medicaid. The subsidies that help people afford health care are like any tax deduction — a cost that taxpayers absorb to make our economy work better. Many if not most Americans will end up repaying the taxpayers in their lifetimes and helping other Americans afford coverage.
4. It finally holds insurance companies accountable.
Providers must now spend at least 80 percent of your premiums on actual care or rebate the difference. This small check on their business practices may be way the growth of the cost of private care is slowing even as the economy improves.
5. The pre-Obamacare health care system is disgusting and indefensible.
Coverage was capped fueling floods of medical bankruptcyies. People were denied care when they were sick. Many were paying for coverage that was nearly useless. Insurers raised rates without any accountability. Meanwhile an estimated 50 million remained uninsured often only receiving care when they were so sick they had to go to an emergency room, passing those costs on to everyone else. Still an estimated 26-45-000 Americans died each year for lack of insurance in the richest country in the world. And this is what the GOP is promising that we’ll go back to each time they demand repeal.