Millions of ordinary Americans closed out 2017 with a powerful message to the Trump Administration and GOP lawmakers about the nation’s health care. Despite efforts to make it harder to re-enlist for insurance plans, consumers signed up in strong fashion for health insurance under the Affordable Care Act. Their actions spoke loudly against the claim that Obamacare is dead. Nope, it’s popular and in high demand.
That 8.8. million Americans had sought Obamacare by the Dec. 15 general program sign-up deadline came as a pleasant surprise to ACA supporters. They were glum because the administration had halved the application time and slashed the money for advertising and other outreach — programs that proponents had considered necessary so those covered on ACA exchanges wouldn’t only be the sickest and oldest Americans but also the healthy and young. Administration officials also said little or nothing to support or promote Obamacare sign-ups, while the President and GOP lawmakers spent the first year of a new Congress and administration assailing the ACA, including a failed effort to repeal and replace it.
Partisans in Congress, as part of a more than $1.5 trillion bill to change the nation’s tax system, killed the ACA’s individual mandate — the requirement that all Americans show, as part of the annual tax returns, that they had health insurance or face penalties. That move, independent and nonpartisan analysts have said, will mean 13 million Americans will lack health coverage by 2027, and average health insurance premiums will go up by 10 percent each year for the next decade. With the prospect that the tax bill and the GOP budget plan will force billions of dollars in cuts, too, to Medicare and Medicaid, and with the unpopular individual mandate gone, President Trump has claimed that he and the Republican Congress have killed Obamacare.
What, then, to make of the 2018 enrollment figures? They almost equal the 9.2. million sign-ups the ACA racked up in previous years — and a dozen states, representing even more Americans, have offered extended deadlines to sign up for Obamacare (Maryland permitted enrollment until Dec. 22, while District of Columbia residents may seek coverage until Jan. 31 — which also is the deadline in the big New York and California markets.) Further, it’s unclear how many Americans will be automatically re-enrolled in ACA coverage and then determine whether to keep or drop it, as typically occurs after the sign-up deadline passes. The numbers also may change because there is a special, 60-day period for folks who may have lost their ACA coverage due to an insurer’s withdrawal from an exchange.
The New York Times, taking note of Republican loathing for the ACA and for public support of health care, in general, also reported that the strong Obamacare sign-ups show that “despite all the politics, millions need the insurance. Nearly half of all plan selections this year — 4.1 million of the 8.8 million — occurred in the last week of open enrollment. More than one-fourth of the people who signed up this year — 2.4 million — were new customers, and 6.4 million people returned to HealthCare.gov to select plans or were automatically re-enrolled.”
The newspaper reported that the “largest numbers of sign-ups this year were in Florida (1.7 million), Texas (1.1 million), North Carolina (524,000), Georgia (483,000), Virginia (403,000), Pennsylvania (397,000) and Illinois (340,000).” An Associated Press analysis found that 4 out of 5 Obamacare enrollees live in states President Trump relied on to get into the White House.
In my practice, I see not only the major harms that patients suffer while seeking medical services but also their giant struggles to access and afford medical care, especially as its costs keep skyrocketing. It would be great in the New Year if the president and GOP lawmakers will show Americans more how they plan to improve the nation’s health care, rather than how they can savage social safety programs they despise but taxpayers have come to appreciate — including Obamacare. This isn’t about political ideology that borders on a kind of theology. The results matter a lot to tens of millions of Americans, their health — and the nation’s economy. Our political leaders should govern themselves accordingly.