What’s Left: Obamacare: To Reform or Repeal?

A few weeks ago, insurance companies began announcing their intentions to withdraw from Obamacare insurance exchanges. Political commentators continue to criticize Affordable Care Act’s (ACA) central policy initiative. While these criticisms are merited, Republicans have nonetheless pounced on these limited and narrow problems in an effort to denounce the entirety of the ACA itself. Aided by inflated “I-told-you-so” rhetoric, we’re now hearing yet another round of renewed calls to repeal Obamacare outright.  Give me a break… 

While recent reports on the healthcare exchanges highlight valid concerns, the exchanges in question have nonetheless been successful as a whole. Current numbers show that 12.7 million people are now enrolled in these exchanges. This insurance is widely agreed to be affordable, and participants in the exchanges can receive cost assistance if they qualify, helping low-income people afford coverage. The exchanges were conceived as a way for people to purchase affordable, easy-to-understand coverage without having to rely on their employer for insurance. For these purposes, the exchanges have been successful. While these exchanges must be adapted to better suit the needs of private insurers (who have lost money by insuring unhealthier patients), the basic premises behind the exchanges are sound. They should be retooled or reworked, not repealed.

In addition to the exchanges, Obamacare as a whole has been markedly successful, too, for a number of reasons. Since the ACA has taken effect, roughly 20 million people have been added to insurance rolls, according to the latest government data. 5.7 million of them have been young adults, such as Colgate students, who have been able to remain on their parents’ health insurance plans thanks to the ACA. This has translated into the largest reduction in the rate of uninsured patients in nearly 40 years, a trend confirmed by multiple independent studies.

Furthermore, the ACA’s trademark expansion of Medicaid has notably improved healthcare access for our nation’s most vulnerable. The overall expansion of coverage has led to positive healthcare developments, including an increase in diagnoses for curable diseases and expanded insurance enrollment for America’s sickest patients. And let’s not forget that because of the law, insurance companies can no longer deny coverage based on a pre-existing condition.

Even some of Obamacare’s lesser-known policies have greatly improved life for American patients.  For example, insurance plans are now legally required to cover management of chronic diseases, such as diabetes. Not to mention that all of this is costing less than expected, with the Congressional Budget Office repeatedly downsizing its cost predictions for the ACA, often by billions of dollars.

It’s worth noting that Obamacare was always about creating effective solutions to pressing healthcare problems. However, it was also about addressing two more fundamental issues: Is access to affordable healthcare a fundamental right for all Americans, and if so, should the federal government alter the healthcare market to realize this right? For both questions, conservatives would answer “no.”  

The recent developments about the Obamacare exchanges serve as a proxy to this fundamental debate. Healthcare exchanges can be fixed, policy solutions can be implemented, and they should. But Republicans would rather completely gut a largely successful policy for ideological reasons, rather than seek out solutions to expand coverage to all Americans and reduce costs for patients. Obamacare has its critics on both the left and right (including myself), but it has brought us closer to a universal healthcare system than ever before. Repealing it outright would jeopardize the well-being of millions of people. More importantly, this would take us back to a darker time in healthcare history.