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Push on to implement Obamacare

Published 11/16/2013 12:00 AM
Updated 11/15/2013 04:07 PM

Democrats in Congress must resist what has to be a growing urge to run for the exits and accept any fix that can provide some immunization from the political contagion spreading from the botched launch of Obamacare.

It would do Democrats no good to accept a legislative "fix" that further unravels the health care law. Democrats own it, and if they join Republicans in undermining it, they will see no political benefit. No, the best option is to stick it out with the hope that in the next few months the program can get up and running as intended.

There really is no other choice. A simpler and arguably better solution would be expansion of Medicare to all, but it's not politically viable. If Obamacare fails, Republicans seem happy to leave things as they are, with tens of millions of citizens having no access to health insurance, including many who most need it.

That leaves making the best of Obamacare.

The administration has to figure out a fix to the online health insurance exchanges, which seem to be working fairly well in states, including Connecticut, that chose to operate their own, but continue to flounder in states - mostly Red - that let the federal government run them. And because many of those Red states have the highest rates of uninsured citizens, those citizens, hospitals and the health care systems promise to benefit most from Obamacare if it works (the irony is thick).

Perhaps taking a few pointers from the states who are getting it right, the contractors working for the government should, in time, get the exchanges operating.

The more serious problem is President Obama's oft stated, and untrue, assurance that everyone satisfied with their health insurance plans could keep them. In reality, millions of the independently insured are facing policy cancellations because their substandard, but more affordable, policies do not meet the minimum requirements of the Affordable Care Act (ACA).

At a press conference Thursday the president essentially explained he thought he was telling the truth, confident that a grandfather clause in the voluminous law allowed individuals to keep these plans. In fact, it only protected plans in place when President Obama signed the law in 2010. Whether intentionally deceitful or just clueless about the nuances of his signature policy achievement, this misstep by the president is inexcusable. It has caused great damage to his credibility and to the ACA.

The solution President Obama offers, allowing insurers to extend these plans for another year, has significant problems. How many insurers will want to extend on a temporary basis, having prepared to move on to the new Obamacare model? Cooperation of state insurance commissioners would be necessary, but how can the administration count on that, particularly in Republican-leaning states?

The better option may be the Senate bill presented by Sen. Mary Landrieu, a Democrat from Louisiana, that would amend the act to allow people to keep these plans as long as they want. This may cause some problems for designing and balancing the risk pools necessary to keep premiums affordable in the health care exchanges. However, the number of these independent policies is relatively small in the overall picture and, in time, individuals should gravitate to better plans in the exchanges.

What Democrats cannot accept is the plan presented by Michigan Republican Rep. Fred Upton in the House - and approved 261-157 Friday with 39 Democratic votes, not exactly a rebellion. This poison pill is designed to fatally damage the ACA. It would not only allow individuals to keep existing plans, but allow new customers to sign up for substandard plans, expanding the market, playing havoc with risk assessments, driving up exchange premiums and undermining the program.

This is a fine mess the president has gotten congressional Democrats into, but they have to stick with him to get out of it and, more importantly, to successfully implement a health insurance program intended to cover all Americans.

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