To paraphrase Mark Twain, reports of Obamacare’s death have been greatly exaggerated.
Despite repeated attempts, the Republican majority in Congress has failed to repeal the Affordable Care Act, better known as Obamacare. But that doesn’t mean the program’s future is secure. While they haven’t been able to kill it in one blow, Congress and the Trump Administration are trying to bleed it to death.
Last year, the White House decimated the advertising budget designed to inform Americans about the annual sign-up period for health plans offered through the ACA’s insurance exchanges. It also got rid of the “navigators” — people hired to help families understand the various insurance plans available and choose the one that’s best for them.
As part of last year’s $1.3 trillion tax reform bill, Congress repealed the mandate that required taxpayers to sign up for a health care plan — thereby ensuring a large insurance pool that included younger and healthier workers. As a result, insurance premiums are rising. And the White House is allowing states to add various work requirements to Medicaid — the insurance program for the poor that Obamacare expanded. This would enable states to restrict eligibility for Medicaid, despite the fact that the vast majority of poor people are working.
So while Obamacare survives, these various strategies are taking a toll on the program’s effectiveness. In 2017, the number of uninsured Americans went up by 3.2 million — the first increase since Obamacare’s passage.
Now comes the latest effort by the White House and Congress to cripple Obamacare — the expansion of short-term, so-called “junk” insurance plans. This move would further drive up the cost of insurance premiums while leaving millions of Americans with inferior coverage.
Under current law, people are allowed to purchase short-term health insurance for up to three months under special circumstances such as when they are changing jobs. These short-term plans do not have to comply with coverage requirements under the ACA, because they are supposed to be temporary. For example, they don’t have to cover people with pre-existing conditions. They don’t have to cover basic benefits such as maternity care or mental health and substance abuse treatment. And they can include annual or lifetime caps on insurance benefits. None of these things is allowed under Obamacare.
The White House is proposing to allow these temporary health plans to last as long as a year – or even longer. Such lower-cost, short-duration policies could be attractive to younger and healthier people, shrinking the insurance pool and driving up premiums for others. The goal is to undermine Obamacare’s finances and drive the plan out of existence. It’s a backdoor way to accomplish what Congress wasn’t able to do directly – get rid of Obamacare.
Fortunately, insurance companies and their practices are still regulated at the state level. So there are steps we can take in Springfield to fight back against this effort to undermine Obamacare by restricting coverage and driving up premiums.
I have introduced Senate Bill 2388, which would protect Illinois consumers by restricting the sale of these short-term “junk” insurance policies in our state. It would prohibit the insurance companies that sell them from excluding people based on pre-existing conditions (about 5 million in Illinois), would maintain them as short term policies only, and require clear disclosures so consumers know exactly what kind of coverage they are getting – or not getting.
Obamacare has made an important difference for people and families across our state, providing comprehensive health coverage to 850,000 Illinoisans who couldn’t previously afford it. It has meant peace of mind for the millions of people with pre-existing conditions who were excluded from coverage. Most important, it has moved us closer to the goal of universal health coverage, so every individual and family can access affordable care as a right and not a privilege.
We may have warded off a fatal blow to Obamacare in the Congress. But it will take continued vigilance and public pressure to keep the Trump Administration from further harming it by undermining coverage requirements and driving up premiums. We can lead that fight in Illinois by cracking down on “junk” insurance.
State Sen. Heather Steans, a Democrat, represents the 7th District on Chicago’s North Side.
