What’s Next for Obamacare?

The Affordable Care Act (ACA), or Obamacare, is a health reform law that was introduced back in March of 2010. Since its implementation, good and bad reviews have been given from experts and consumers alike. There’s no denying the benefits of Obamacare, but there are also some pitfalls worth noting.

The main goal for Obamacare was to ensure that private and public insurance would be made available to 24 million Americans before 2023. Many insurance companies baulked after the Affordable Care Act rolled out because of the stricter regulations, which required all insurers in the marketplace to lower their costs, increase their benefits, and offer new funding for preventive services and public health. This was all an attempt to make health care more affordable for consumers and to improve the public health workforce.

Why Obamacare was Needed
Health care reform came about at a time when it was greatly needed. The following problems were widely seen across the nation:

• A high uninsured rate: Back in spring of 2014, there were 42 million Americans below 65 who weren’t insured. This rate would have only risen without the Affordable Care Act.
• Poor health: The medical expenses in America was at an all time high, especially when compared to other industrialized countries. Plus, the life expectancy for America was too low for the amount of money being spent on health care.
• Unsustainable health care spending: The amount of money being spent on health care made up 17.2 percent of the country’s gross domestic product (in 2011).
• No emphasis on preventive care: Many of the chronic illnesses and deaths witnessed in the U.S. are preventable, such as diabetes, obesity, heart disease, cancer and high blood pressure. Instead, 75 percent of health care expenses go to treating these diseases.
• Health inequalities: Income, race and pre-existing health conditions all created inequities in health care. Insurers were prejudiced and refused to offer coverage to certain individuals or would charge prohibitively high rates and provisions in exchange for coverage.

The Affordable Care Act to be Repealed?
There’s talk about Congress sending President Obama a bill to repeal core parts of the Affordable Care Act. Despite the good that Obamacare has brought, there are big critics that believe the health reform is unworkable, unpopular and unaffordable. The problems that are seen with the reform are stacking up as time moves on, like the failing state exchanges, rising premiums, fewer choices, higher deductibles and disintegrating co-ops.

According to polls done by Real Clear Politics, 50.2 percent of U.S. residents dislike Obamacare and only 42.5 percent support it. There was an Urban Institute event held recently where the supporters of Obamacare discussed the next steps for improving the Affordable Care Act. What was mentioned was more government intervention, more government spending and increased government control. In the end, this would mean patients and providers alike would be at the mercy of government regulators.

Another Approach for Obamacare
An alternative solution to the issues we’re seeing with Obamacare would be to promote a more patient-centric, market-based reform. There are many plans that have been proposed to improve the health care reform. Many of them share similar ideas, such as:

• Removing policy and regulatory hurdles that prevent competition and choice, and ultimately driving up health coverage costs
• Reforming the tax treatment of medical care to help promote personal ownership of health care
• Restoring Medicaid so that low-income Americans can have greater access to the program
• Creating a modernized Medicare program that addresses the needs of the program’s fiscal, demographic, and structural obstacles

A Replacement for Obamacare
Reports show that Paul Ryan, Republican Speaker of the House from Wisconsin, talked about advancing an alternative to the Affordable Care Act. However, filling in the blanks with the fine details will be the next obstacle. The following challenges would have to be addressed in doing so:

• Sound financing for the program. The ACA rose health care spending by $2 trillion and uses financing from tax increases. It also has questionable offsets and draconian Medicare cuts.
• Offering a more stable and liberating health care market. The thousands of pages of regulations Obamacare enforces caused major disruption to the health care industry. Some suggest allowing a longer time period for the marketplace to adjust to changes.
• Allowing easier financing that is transparent and direct to consumers. This way individuals have more freedom and ownership over their health care based on their needs.

Obamacare in 2016
In February this year, the Obamacare enrollment numbers were released and weren’t all that impressive. Normally, the enrollment numbers are big news, but not this time around. This last period we saw nearly 13 million people enroll in health care plans through the health care exchange. It’s expected that this number will decrease as people begin struggling to pay their premiums. Best case scenario is that there will be one million more people covered in 2016 than in 2015.

Obamacare reached its main goal of reducing how many uninsured Americans there are in the U.S., which decreased by 16 million since 2013. But when you look at how many people are actually participating in the health care market, it’s not as predicted. It was expected that there would be 21 million people in the insurance exchanges in 2016.

This doesn’t necessarily mean the health care reform isn’t working, but higher numbers of enrollees would help to stabilize the markets and make them more sustainable.

On the bright side, enrollment could potentially rise continuously, but at a much slower rate. It could begin as early as 2017, when Americans are no longer allowed to keep their old plans. This should boost the number of people enrolling in the marketplaces.

The down side would be higher uninsured rates due to the lack in enrollment numbers. This could lead to markets in certain areas becoming less competitive, making it too expensive for individuals to obtain. This is more likely to happen in less populated areas that always had less competitive markets and higher premiums. This would leave them under-insured in a market that was supposed to increase their health care opportunities.