The tragedy of a Trump presidency wasn’t ever going to be vesting executive as well as legislative power in one party, or even the ascendancy of someone so hell-bent on serving himself before others. The tragedy was that he’d make good on his campaign promise not to fix what’s wrong with the Affordable Care Act, but act instead to repeal it leaving the very people he reached with his campaign without health insurance, again.
Over twenty-million people newly possessing health insurance, some for the first time in their lives, and many of them children stand to be abandoned. Many of these same people are the self-identifying “deplorables” who voted for Donald Trump not as a reasoned choice, but as a “fuck it” roll of the dice. Throwing reason to the wind, these fellow citizens are often the most vulnerable among us, the un- and under-employed living in small towns, counties, and cities.
President Trump began the process of dismantling the ACA yesterday afternoon.
As evidence that the GOP has nothing to replace it with, and yet fear cutting off their base at the knees, the initial presidential order directed federal agencies to “ease the burden of Obamacare.” From reporting by The Hill,
It is not clear what practical effects will come from the order.
Of course not. Nothing is clear where there is no guiding plan or steps to be taken, just a vague idea turned into a campaign cause.
Here’s a thought: why not fix the parts that don’t work well?
Insurance companies are ratcheting up premiums both in states where competition is slack, and in response to the pool of insured - without adequate penalties for not fulfilling the individual mandate, many younger and healthy citizens would rather pay the $695 fine than spend more on a policy. This tilts the pool of insured toward less healthy citizens, lowering and in some cases eliminating profit for insurance companies. Clearly $695 does not enforce the mandate.
Businesses exist to make a profit. Where there is no profit to be had, there will be no business. Insurance companies are pulling out of states where they cannot afford to do business.
A personal example: my Blue Cross policy premium runs about $1500-$2000 per month, partly paid by me, partly by my employer. Imagine if I were a young man, healthy, and didn’t want to pay my part. I could save roughly $500 per month by not taking insurance at all and, in less than two months, break even with the penalty I’d pay come tax time.
One solution is raising the penalty to twice the premium of the least expensive policy available on any state insurance exchange. See then how many healthy, yet uninsured people sign up for coverage. This would help level the pool and allow insurance companies to offer more reasonably priced policies while still making a profit.
That’s but one idea. The GOP, in its blood lust for erasing the signature accomplishment of the Obama administration has no interest in fixing what’s broken. Trump, their toady, is only too willing to play along.
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