Thoughts on the ACA, its goals and challenges

Excerpts from an Aug. 1 blog post by Edwin J. Feulner, founder of The Heritage Foundation: For more than seven years, Republican lawmakers, including President Trump, campaigned on a promise to repeal Obamacare.

They rightly noted that Obamacare severely disrupted the health insurance markets, making health plans prohibitively expensive for many Americans. They reminded everyone of President Obama’s hollow promise that those who wanted to keep their health care plan or their doctor could do so if they wished.

We kept sounding the alarm about the damage that Congress had unleashed by foisting the ironically named “Affordable Care Act” on the public, while the Obama administration insulated them from the full costs of the program with taxpayer subsidies that were never even appropriated. We ran the numbers. We chronicled the plight of real Americans suffering under the law.

Fast forward to 2017. The party that ran on a repeal platform now holds the White House and a majority in both houses of Congress. Surely the plug would finally be pulled on Obamacare.

But no. In a vote that ignored the clear will of the American people, the Senate recently voted against taking the next step in undoing this damage.

And make no mistake, undoing is exactly what is required here. No half-measures will do. Repeal is a must.

Obamacare cannot be fixed or bailed out. The law’s mandates, insurance regulations, taxes, and expansion of government simply go too deep. No partial effort to address these problems can truly free Americans from the high insurance costs and limited choice they now face.

From an Aug. 2 Brookings Institute blog post:

A central provision of the Affordable Care Act is the national expansion of Medicaid coverage to Americans earning less than 138 percent of the federal poverty level. A Supreme Court decision in 2012, however, ruled that states had the option to refuse to participate in the Medicaid expansion. Currently, 31 states plus the District of Columbia have expanded Medicaid.

In 2015, Jeremy Barofsky, a Brookings nonresident senior fellow, found that among the states that had not expanded Medicaid, there was a substantial gap in coverage for those with incomes too high to qualify for Medicaid, but too low to obtain federal premium subsidies on insurance exchanges. This created a counterintuitive situation in which the poorest were denied coverage while those with slightly higher incomes could receive premium subsidies to buy health insurance.