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Obamacare Under President Hillary Clinton

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Obamacare Under President Hillary Clinton

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The office building of health insurer Anthem is seen in Los Angeles, California February 5, 2015. REUTERS/Gus Ruelas

We may be getting ahead of ourselves assuming that Hillary Clinton will be next president, but let’s proceed on that (comforting) notion. Few are better prepared to preserve and improve upon the Affordable Care Act than Clinton, who’s long immersed herself in health care policy.

Obamacare is complicated — built that way to get past an army of vested interests and a hard wall of Republican opposition. But though it has things that need fixing, all in all, the program has been a success.

Obamacare has brought coverage to some 20 million more Americans. It’s made individual insurance cheaper than it was in 2010, according to Health Affairs. Average premiums are down. (The premiums going up would have risen more without the law.) And surprise, Obamacare will cost $2.6 trillion less over five years than earlier estimated, a recent Urban Institute study reports.

One undeniable frustration has been the high cost of coverage for many in the marketplace. Now some of those “found” trillions could go to raising subsidies, making coverage more affordable.

Clinton proposes a “buy in” option to Medicare for Americans 55 to 65. One must currently be 65 or older to automatically qualify for Medicare. Clinton would pay for this Medicare expansion through a higher investment surtax for upper-income people.

Lowering the Medicare age is a fine idea on several counts. Medicare has been good at controlling the cost of health care, and the beneficiaries love it. Since older people tend to use more health care than younger groups, moving them into Medicare takes some pressure off the insurers in Obamacare. At the same time, bringing younger old people into Medicare strengthens the Medicare risk pool.

Bernie Sanders promoted “Medicare for All” in his presidential run, and the idea is solid. Clinton’s gradual approach, “Medicare for More,” with better-planned funding, tops it for political palatability.

Assessing Donald Trump’s health care plan takes no time at all. Trump says he’d repeal Obamacare and replace it with “something terrific.”

The Republican House replacement plan, released by Speaker Paul Ryan in June, offers more specifics. To its credit, the proposal recognizes the need for a strong government hand in guaranteeing access to health care — even as it opens the window for more privatization, which adds complexity.

Gone would be the mandate requiring everyone to obtain health coverage. To discourage people from seeking coverage only after they’ve become sick, the proposal lets insurers charge what they may to those who hadn’t been buying insurance. The average Joe understands the risks of not maintaining coverage and of getting seriously ill. Right?

Unlike Obamacare, the House Republican plan sets no national standards for minimum coverage: Ordinary people will read, study and compare insurance policies. Perhaps.

The Republican plan takes away from older Americans. It would not lower but raise the Medicare age to 67. This would unfortunately make the Medicare risk pool older and sicker. The proposal would also let private insurers charge a lot more than they do now to those not quite old enough for Medicare. Last but hardly least, it would move Medicare toward a voucher system.

The most serious flaw in the Republican plan is what’s missing: a price. If you’re not going to say how much it’s going to cost, why not throw in free facials on fur-lined couches?

Notably few Republicans these days call for repealing Obamacare without a replacement. A fully fleshed-out alternative would be most appreciated.

Clinton remains intent on keeping and making it better. Happily, the likelihood of her being in charge is rising. Health care mechanics is Clinton’s specialty, and that’s more good news for Obamacare.

Follow Froma Harrop on Twitter @FromaHarrop. She can be reached atfharrop@gmail.com. To find out more about Froma Harrop and read features by other Creators writers and cartoonists, visit the Creators Web page at www.creators.com.

Photo: The office building of health insurer Anthem is seen in Los Angeles, California February 5, 2015.   REUTERS/Gus Ruelas

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Froma Harrop

Froma Harrop’s nationally syndicated column appears in over 150 newspapers. Media Matters ranks her column 20th nationally in total readership and 14th in large newspaper concentration. Harrop has been a guest on PBS, MSNBC, Fox News and the Daily Show with Jon Stewart and is a frequent voice on NPR and talk radio stations in every time zone as well.

A Loeb Award finalist for economic commentary in 2004 and again in 2011, Harrop was also a Scripps Howard Award finalist for commentary in 2010. She has been honored by the National Society of Newspaper Columnists and the New England Associated Press News Executives Association has given her five awards.

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3 Comments

  1. Dominick Vila August 12, 2016

    The benefits provided to our society by the Affordable Care Act are so many that they are impossible to quantify in a medium like this. Suffice it to say that making comprehensive medical care to millions of Americans who were previously not insured because they could not afford the high premiums, and ensuring all Americans, including those with pre-existing conditions, have access to healthcare, transformed a draconian medical system, into a humane and efficient system.
    Having said that, Obamacare, as it is popularly known, is just a first step towards a more inclusive and affordable system. Its major flaw is the fact that it has not been able to control the rising cost of medical care in the USA. Insurance companies, pharmaceuticals, and manufacturer of medical equipment, continue to charge astronomical prices for their services. Expanding MEDICARE services is a logical and effective way to strengthen healthcare services in the USA, and help control cost by taking advantage of an existing, and very effective institution. The only cautionary note is that the expansion must be done carefully, to avoid impacting the solvency of one of the pillars of our “safety net”.

    Reply
    1. Joe Steel August 13, 2016

      The only cautionary note is that the expansion must be done carefully,
      to avoid impacting the solvency of one of the pillars of our “safety
      net”.

      How do you imagine that working? Medicare Part E (everyone but those covered by Parts A, B, C and D)?

      We should be able to keep the funding and claims separate. Everyone would pay the Medicare tax until age 65 and a Part E tax to cover pre-65 benefits. At age 65, the Part E tax goes away. The funds would be kept separate and claims would be paid from the appropriate fund.

      Reply
  2. drdroad August 13, 2016

    In America we tend to think of ourselves as smarter, wiser, ‘better’ than the rest of the world. And at times I’d agree with that. But what I don’t understand is how we can take a look at how the rest of the developed world does health care and not adopt a similar system. Almost every developed country in the world has a single payer system and every one that does has lower total Health Care costs, as low as 50%, of ours. Can we question the care people in counties like Germany, England, France get?

    Reply

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