Why Obamacare trumps Medicare for All

The picture of Joe Biden and Bernie Sanders
Joe Biden’s presidential campaign expanded his critiques against “Medicare for All” and pressed its opponents to fight to protect and expand the Affordable Care Act (ACA), which the former vice president played a crucial role in ushering through Congress.

The Houston Chronicle, Editorial Board

Despite Republican attempts to bleed it to death, there are new signs that the Affordable Care Act can survive. The question now is whether Democrats will abandon it for some form of Medicare for All.

Among the positive signs, premiums for most ACA plans offered in the Houston area will go down about 1 to 2 percent in 2020. In contrast, premium rates for Obamacare plans across the country are expected to go up about 3 percent, but even that is good news given premiums nationally increased about 30 percent last year.

Those price hikes were in part due to elimination of Obamacare’s individual mandate penalty, which the Republican-controlled Congress repealed in 2017. With the penalty gone, many healthy Americans decided to forgo insurance. That led insurance companies saddled with sicker risk pools to raise their rates.

With the ACA on the ropes, the Trump administration issued new rules benefiting Obamacare alternatives by expanding consumers’ access to short-term and association health plans. These cut-rate plans aren’t as extensive as the ACA’s, which means their policyholders may not have the coverage they need if they get seriously ill or injured.

The administration didn’t seem concerned about that. Nor did it seem concerned about people’s health when it slashed the ACA’s outreach budget, severely limiting the program’s ability to enroll participants. Outreach funding was cut from $63 million in 2017 to $36 million in 2018 and only $10 million this year.

Despite such blatant attempts to blow up Obamacare, it is becoming more ingrained. In fact, several insurance companies, including Cigna, Oscar, Bright Health, and Centene, are expanding the number of states where they will offer ACA plans. That’s a clear sign that companies that once feared losing money with Obamacare have found ways to make a profit.

That doesn’t mean the ACA is no longer in jeopardy. The number of individuals who selected an insurance plan on the ACA marketplace has dropped from a peak of 12,681,874 in 2016, the last year of the Obama presidency, to 11,444,141 this year.