published Tuesday, November 19th, 2013

Don't shoot! Yes, reform is out of the barn, and it can work

There's certainly lots of hubris in Washington right now -- even more than usual.

With the president admitting a fumble on the roll-out of the Affordable Care Act's federal health exchanges, the GOP is giddy with hypocrisy.

"It's hard to see how to fix all the problems with Obamacare as long as the law stays on the books. Just take the current problem we have with cancelled policies," said Tennessee Sen. Lamar Alexander last week during a visit to the Chattanooga Times Free Press.

Alexander's comment came on the heels of the Senate's vote -- including Alexander's -- to pass a bill to allow insurance companies to sell individual health coverage, even if it falls short on the required standards in Obamacare, as long as it makes good on Obama's pledge that if people like their insurance they can keep it.

In other words, the faint-hearted in Congress who like to rain on anything Obama are waffling on Americans -- even if Obama's accomplishment was a GOP idea in the first place and even if the people who got insurance cancellation notices were a tiny sliver of all the people helped by the legislation.

In his "fumble" comments, Obama said he largely meant people already covered by insurance through their employers wouldn't have to change, but he understands now that he spoke too broadly and did not understand completely how the insurance giants would operate under the new law.

Here's how they operated: Insurers have offered and sold policies that don't live up the standards of the ACA -- things like covering prescription drugs, mental health treatment and maternity care. Things like no life-time limits for claims. Still, under ACA, those non-conforming plans were grandfathered in.

Insurers could have tweaked those plans, adding what was missing or dropping limits. And since private individual insurance policies are usually 12-month contracts, the insurers have had three contract cycles to tweak them before Obamacare rolled out. Instead, they kept right on selling substandard plans, then suddenly sent out cancellation notices when, first a different president was not elected in 2012, and, second, when the effective date of the ACA came and went without a successful repeal vote.

Alexander says Obamacare "outlawed" Tennessee's CoverTN plan, but that's not true. CoverTN wasn't outlawed: Tennessee and its insurers chose to cancel the program in the 11th hour instead of doing what other states like Kentucky did to embrace the program by legitimately covering both private pay customers and Medicaid recipients.

The program is working great in Kentucky, by the way. Don't you find it odd that the exchanges in states that worked with the ACA have smoother sign-up systems?

But Alexander is right about one thing: The horse is "out of the barn."

The sliver of folks who got cancellation notices -- about 6 percent of all Americans or about 5 million nationwide (Tennessee's entire population is about 6 million, by the way) -- will almost all get the same or much better coverage and many of them will get financial help to purchase it. Only about 3 percent will have to pay more, according to an MIT professor who oversaw Massachusetts Romneycare reform.

Meanwhile 80 percent of all Americans -- those who received insurance through their employer or are already enrolled in a government program -- won't see any change at all. Except they can't be turned down for insurance next time should they change employers, according to the Kaiser Family Foundation.

Another 14 percent of all Americans who are currently uninsured will be able to be covered because of the ACA.

Don't let the naysayers sway this accomplishment -- even with its website fumbles and GOP sabotages.

For all that good that's being done, let's hope Alexander and his friends don't recover the fumble and run away with the ball.

about Pam Sohn...

Pam Sohn has been reporting or editing Chattanooga news for 25 years. A Walden’s Ridge native, she began her journalism career with a 10-year stint at the Anniston (Ala.) Star. She came to the Chattanooga Times Free Press in 1999 after working at the Chattanooga Times for 14 years. She has been a city editor, Sunday editor, wire editor, projects team leader and assistant lifestyle editor. As a reporter, she also has covered the police, ...

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soakya said...

we'll see what those 80% who receive their insurance from their employers see when the employer mandate kicks in. the law defines a large employer as a company that employees 50 full time equivalent employees, and full time is considered 30 hours a week. for example, if you have 60 part time employees who work 26 hours a week you have 50 full time equivalent employees and you will be subject to the mandate. this mess you see now is nothing compared to what's coming. 5 million who will lose their insurance now will be a drop in the bucket compared to 2015 losses. you own this liberals.

November 19, 2013 at 12:13 a.m.
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