.. West Virginia started near the bottom of the pack in 2013. It had high rates of uninsurance and poverty, and ranked low on measures of public health. But state officials, health care providers and local advocacy groups embraced the Affordable Care Act wholeheartedly — and avoided the word Obamacare. The state didn’t just expand Medicaid, but also took extra efforts to identify residents who were likely to be eligible for new insurance, sought them out, and made it easier for them to sign up
.. In areas with large populations of Native Americans, the uninsured rate does not fully capture the population’s access to health care, since tribal members often get care from the Indian Health Service instead of traditional health insurance.
The Best Way to Save Obamacare
As someone involved in the debate over the Affordable Care Act from the start, I don’t find these unhappy events all that surprising. From the outset, I’ve argued that without a public option — a Medicare-like plan that would be available to all Americans buying health insurance — insurance competition would dwindle and premiums would skyrocket. Now that they have, it’s time to do now what we should have done then: take the simplest route to a more stable and affordable health care system.
.. We’re already heading toward single payer in sections of the nation — only it’s a private plan doing the paying. Next year, five states will have only one insurer in their exchanges, the online marketplaces set up to allow uninsured Americans to buy subsidized coverage. Nine more states will have just two insurers.
.. The diminishing number of choices doesn’t just hurt consumers; it also makes it harder for regulators to use antitrust tools to push back against this consolidation. Who wants to be the official accused of causing an insurer to leave the exchanges? It’s a perverse equation: As the number of insurers goes down, the leverage they have over regulators goes up.
.. In polls conducted in 2009 and 2010, substantial majorities of Americans said they would feel better about being required to have coverage if they had the choice of a public plan.
.. In polls conducted in 2009 and 2010, substantial majorities of Americans said they would feel better about being required to have coverage if they had the choice of a public plan.
How Trump Ended the Obamacare Debate
Republicans once made opposition to the Affordable Care Act central to their message—but their nominee understands the dangers of taking health care away from those who need it.
Less than 60 days out from the presidential vote, however, the issue of Obamacare has all but vanished from the Republican message.
Donald Trump remains virtually silent on Obamacare. Look at Trump’s last 10 speeches—the number since Trump began delivering prepared-text teleprompter remarks. All came during a period of bad news about Obamacare. But, according to the texts released by the campaign, one Trump speech didn’t mention Obamacare at all, while several others devoted just a few—really, a few—words to the subject.
.. Trump early grasped something that has eluded more conventional Republicans over the past seven years: As compared to the Obamacare status quo, mainstream Republican health-care proposals would shrink coverage—and raise out-of-pocket costs—for many millions of Americans.
.. Obamacare is a flawed, unstable program. But it’s something.
.. Republicans will not regain an opportunity to reform health care their way until 2021. By that time, the Affordable Care Act will have been the law of the land for eight years. Its defects will be more visible than ever. The expectations generated by the act will be more entrenched than ever, too.
The Incredible Shrinking Obamacare
the law is poorly designed to induce younger, healthier people to get into the system. The penalties attached to the individual mandate are too weak. The subsidies are too small. The premiums are too costly. The deductibles are too high. Many doctors aren’t participating in the networks.
.. the exchanges are attracting sicker, poorer people, who drain money, and are not attracting the healthier people who pour money in.
.. 24 million Americans still lack health insurance. That means less competition. Before too long, a third of the exchanges will have just one insurer in them.
.. Blue Cross Blue Shield has requested a 62 percent increase for next year in Tennessee and an average 65 percent increase in Arizona. Some experts put the national requested increase at 23 percent.
.. “Obamacare’s insurance expansion is on the path to looking like other safety net programs we know, offering limited services to a predominantly low-income population.”
.. “The exchange population — 85 percent of which qualifies for financial assistance — looks a lot like the Medicaid population. And with it, we’re seeing the start of the Medicaid-ization of exchange plans: narrow networks with no frills.”