We generally see the 2.0 version of a software app clearing up some bugs, adding a feature or two, and fine-tuning others. Obama Care will be different, far different. It needs a complete overhaul, a rewrite, and it needs it now. We can’t wait.
Yes, this major social program did some good. One could argue a lot of good. But, it just isn’t working well, and in some cases it isn’t working at all.
The problems are many, but here are the major ones:
- Exchanges have closed down. At last count it was 25 of 33 were shut down;
- About one-third of the counties in the U.S. have only one plan to choose from…not really a choice;
- The plans are expensive and getting even more expensive.
- Deductibles are (to use a teens word) G-eye-normous. A typical 19 year-old healthy college student just purchased a plan with a $3600 deductible for $221 per month in my county.
- Some employers are now required to enroll employees or face a penalty; and yet they don’t really have any reasonable options;
- And finally, those now famous words that still bring anger to even the most level headed person, “if you like your doctor you can keep him….and if you like your insurance plan, you can keep it”. Neither is true. If it happened to work out for you, it was shear luck and against all odds.
What is the answer?
Reverting back to the status quo that many conservatives vow to do is not an option. The previous existing individual health insurance marketplace was ripped to shreds and reconstituted by Obama Care. There isn’t anything available to revert to.
Here are some thoughts:
- Scrap the employer penalty. It was onerous, not well thought out and terribly penal because of the lack of options;
- Use Obama Care exclusively for Medicaid. It is best suited for it and basically operates as a substitute for Medicaid for up to 80% of the current insured’s;
- Allow the individual market to reconstitute itself for non Medicaid insured’s, operate in all markets and provide nationwide coverage to insured’s;
- Allow the new markets to underwrite new entries thus placing the onus of insurability where it belongs, with the insurer.
- Make Obama Care available to those who are uninsurable after underwriting;
No easy solutions and no quick fix. It will take several years to have significant changes implemented and working well.