Repealing Obamacare will create more choice for health insurance companies, but not for people trying to buy health insurance. Despite presidential promises, it is also economically impossible to cover pre-existing conditions for all Americans without having an insurance mandate – unless The United States moves to a single-payer healthcare system.
The Republican Party has been promising to repeal Obamacare for years. They have to do it or their voter base will go insane (if they aren’t already).
Both the House and Senate bills guarantee higher cost premiums and co-pays for older people, women, and people with pre-existing conditions. They allow states to once again choose what is and what is not covered, while slashing almost a trillion dollars from Medicaid so they can give tax breaks (some even retroactive) to the richest people in the country. What a moral country we have become in the Trump era, eh? The republican “healthcare” bills are nothing more than the republican controlled government declaring poor people should be left to die, the middle class left to struggle, and the rich left to buy bigger yachts.
Increased health insurance costs and decreased healthcare coverage will happen because every American will once again be up against the massive health insurance corporations on their own. Even if republicans manage to keep popular pieces of the ACA, their promise to remove the individual mandate virtually guarantees that the pre-existing conditions protections are eliminated in the long run.
It’s a simple matter of economics.
First, it’s important to point out a fact that gets horribly lost in the chaos of healthcare politics: Americans can already buy healthcare coverage from any health insurance company they want… if they have the money to do so. Paul Ryan and the Republican Party promising “more choice” or “empowering the people” is nothing more than political spin to cover up bad public policy.
Why? Because choice does not equal access: I have the choice to buy a used Ford or a new Ferrari – that doesn’t mean I can afford the Ferrari.
It is astonishingly clear that many Americans – including Donald Trump – don’t understand Obamacare and how all its parts work together. Pieces of Obamacare we don’t like are required in order to have the pieces we do like, so to better understand the interdependencies of the Affordable Care Act, let’s focus on two key aspects: the individual mandate and covering people with pre-existing conditions.
The Health Insurance Industry Is A Business
Donald Trump is just starting to realize how the health insurance market works, and why as a result the Affordable Care Act is so complex. We can, however, narrow down the complexity to the root cause: private health insurance companies have to make a profit or they go out of business. That’s the key to the whole system. If insurance companies go out of business, the entire healthcare industry collapses because it relies on insurance companies – and the US government – to pay the bills.
All other post-industrialized nations worked around this problem by creating a single-payer healthcare system. Even the United States has a single-payer system for part of its population: it’s called Medicare. For all the rest of us, we have to survive in the privatized insurance market in order to afford healthcare.
More Choice: For Health Insurance Companies
A popular aspect of Obamacare is to protect people from being rejected if they have a pre-existing condition. Pre-existing conditions are very expensive for health insurance companies. When health insurance companies have the choice, they will either reject that person, or make the insurance policy price so high that they still profit from selling it (assuming the person can afford to buy the policy in the first place).
So yes, there is “more” choice if republicans repeal Obamacare, but it’s more choice for insurance companies. They get to decide if they want you.
But how do republicans claim they will offer more healthcare choice to consumers? By removing the individual mandate… if they do that we lose all the parts of Obamacare that we like.
Individual Mandate Is Key To Protecting Those With Pre-Existing Conditions
This is the financial reality of relying on private health insurance companies that gets lost in the political fervor of Obamacare. After his first meeting with President Obama, President-elect Trump claimed he wanted to keep the pre-existing condition protection – the part of Obamacare that protects people from being rejected or price-gouged by insurance companies. The problem with that is we cannot keep the pre-existing condition protection AND get rid of the individual mandate. It’s basic economics of the health insurance industry: the individual insurance mandate makes pre-existing condition protection financially possible.
Why does the individual mandate make pre-existing condition protections possible? Because health insurance companies go out of business if they don’t make a profit – there’s that pesky problem with privatized social systems again. The purpose of the individual mandate is so that insurance companies make more money from clients who do NOT use their health insurance: younger, healthy people. Since the health insurance companies make a lot of money from healthy people, that offsets the costs of covering older people who use their insurance as well as those who have pre-existing conditions.
If republicans in Washington eliminate the individual mandate, it is financially impossible to keep the pre-existing condition protection. That’s the basic economics of having a private healthcare system that totally relies on private health insurance companies. And that’s why almost every other post-industrialized country set up a single payer – socialized – system for their entire population.
Do You Want More Healthcare Choice, Or Do You Want Healthcare At All?
It’s not a hyperbolic question. Most American’s cannot afford to buy a decent health insurance policy on their own. That’s basic fact. On the other side of this equation are the insurance companies who only stay in business because they can offset costs as a result of selling policies to lots of healthy people – hence, the individual mandate. If the GOP gets its way and removes the individual mandate, we go right back to unaffordable health insurance, lousy coverage, and no pre-existing condition protection.
Without an established social system to offset costs, the best “healthcare choice” most Americans will get under the republican scheme will be a catastrophic coverage policy. They’re inexpensive insurance policies for a reason: the deductibles and out-of-pocket minimums are so high that those policies are basically worthless unless you lose a limb in a freak vending machine accident. Those are the types of insurance policies we see in the movies: the family thought they were covered, but when someone gets sick the fine print and denial letters prove otherwise. The family goes bankrupt and the kid dies anyway. Not quite American exceptionalism, is it?
The bottom line: the Republican Party promising “more choice” by repealing Obamacare is selling a false set of economic possibilities. They’re failing to mention the fact that 99% of Americans can’t afford a Ferrari.
All the pieces of Obamacare are there for a reason: to make the total system minimally viable. We can’t pick and choose only the ones we like. The only way to balance costs without an individual insurance mandate is with a single payer system – socialized healthcare – exactly like Medicare.
Medicare for all.
