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Trent Franks
Trent FranksRepublican, AZCurrent Position:Congressmansince January 01, 2003
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Fact-Based Article
Obamacare 5 Years Later: Did We Get What We Were Promised?
It seems as though insurance options either cost an arm and a leg in premiums or have $6,000 deductibles and a network of unknown doctors, so it's normal for the public to feel nervous about the possibility of getting sick. So when the Affordable Care Act (ACA), or “Obamacare” as it’s commonly called, was first introduced, there were masses of people who were excited to have healthcare for the first time in their lives.

Proponents of the law said it would increase the overall public health of our nation, since it would extend affordable healthcare coverage options to everyone, especially those who weren’t covered at all. Because the nation would be healthier, baseline costs of healthcare and premiums would drop, and the federal deficit would even decrease. And President Obama promised that everyone would be able to choose their doctors and keep their current insurance plans. Seems like everyone wins, right?

In a March 3, 2016 press release from the U.S. Department of Health and Human Services claimed that an estimated 20 million people gained health insurance coverage because of the ACA, which includes Medicaid expansion, Health Insurance Marketplace coverage, and changes in the law that let people under 25 remain on their parents’ health insurance. It also required insurance companies to cover people with pre-existing conditions who couldn’t get coverage before. At first glance, it seems like Obamacare is doing what it’s supposed to.

Yet the Affordable Care Act, hasn’t quite delivered on its promises, despite some positive effects.

Healthcare Exchanges

After Obamacare was rolled out, the healthcare exchanges set up were supposed to make it easy to find affordable insurance coverage. Each state was supposed to have its own, and the marketplace would eliminate a person’s need to search on their own to find the plan that best fits his or her needs.

But the ACA exchanges are fraught with problems, and enrollment has been low. Plus, subsidies that help offset the cost of higher insurance premiums in 2017 can only be purchased using the exchanges. To top it all off, the cost of implementing and maintaining them has cost a mint, and now state-run exchanges are operational in only a few states. As pressure mounts, some insurance companies are opting not to participate in the exchanges, leaving very few providers in the exchanges. That means fewer options for people looking for coverage.

The Rising Costs of Premiums and Deductibles

According to the Kaiser Family Foundation, the average cost of a single premium for employer-based health insurance in 2015 was $5,963. The employee contribution was $1,255 with employers contributing an average $4,708. Family plans cost nearly $18,142 on average, with most employees contributing approximately a fourth. Plans increased an average of 4.4% from 2015 to 2016, but it will be a big jump in the upcoming year.

In Oklahoma, those covered by Blue Cross and Blue Shield of Oklahoma will see a 76 percent rate increase, a number that’s debilitating to small businesses. Cache County, Wyoming, in budget planning for next year, is expecting to see a 35 percent increase for 2017 for the same plan, forcing them to consider increasing the employees’ percentage of contribution, or consider plans with higher deductibles and fewer benefits. This is not atypical for many small and medium-sized businesses who cannot afford to fully fund their employee healthcare plans. The cost increases are then thrust onto the average person, many already struggling to figure out how to pay for it.

While premiums continue to rise, the benefits don’t get any better. Deductibles continue to increase, too. The average employee saw deductibles rise from $1,000 to $1,500 and $3,000 to $3,400 out-of-network. The way things are going right now, the distribution of costs isn't sustainable for either employees or employers. 

For something that is supposed to be “affordable,” the ACA just isn’t delivering. According to a Texas Medical Center Nielson Survey, 85 percent of respondents in a survey across 5 states (Texas, California, Florida, New York and Ohio) said that they want universal health care. Yet, 87 percent of the uninsured people who visited healthcare exchanges could not afford to pay the premium and out-of-pocket expenses.

Small Changes, Big Implications 

When it comes to premiums, it's clear that employees are paying more for them as well. However, these changes may look nominal on the surface, Family plans increased about $12 a month from last year to this year, and ER copays went up $50. It is the higher costs of deductibles that has kept premiums from dramatically increasing in past years. In order to meet the stipulations of Obamacare, insurance companies can either raise deductibles or raise premiums.

For 2017, there are several states (like Tennessee and North Carolina) seeing sharper hikes in premiums. People in Iowa are seeing as high as a 43% increase, with experts explaining to the state-run government that these increases are actually necessary on the part of the insurer. If politicians refuse to approve of the premium rates, they risk having the insurer drop out entirely in that state and limiting the options for healthcare further.  

Doctors with Borders 

Doctors are caught in the middle of a lot of these battles, but this is not to say they're blameless either. Most medical facilities would like to cut down on medical care waste and increase their customer satisfaction rates, but there are some who are looking to increase their bottom line by any means necessary. A Journal of American Medical Association (JAMA) article specifically addressed waste in healthcare, what some call “overtreatment.”

Denying access to patients who do not have the Rolls Royce of healthcare plans is one way to maximize their funds and bring even more attention to a system that doesn't allow people to keep their doctor. Other healthcare plans force users to stay “within network” for services in order to get a lower price. While this is supposed to help cost, the best care isn’t always available from the cheapest provider. While Obamacare had so much stake in the game because they claimed they would allow people to keep their doctor, it hasn't necessarily worked out that way.  

The Future of Healthcare 

Some people think that this is beginning of more involvement from the government. The excess amount of problems arising from this form of healthcare will likely mean either a complete withdrawal from this system (as the Republicans want) or doubling down on the government merging with insurance into a Medicare-like single-payor system (as the Democrats want). Either way, the Affordable Care Act as it functions now is not effective, and serious changes need to be made. 

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Voter Responses & Comments:
What's happening to our country? First we can't trust our "you can keep your health plan" Prez, then the FBI and the Justice Department, now the integrity of our voting process. M.L. - Libertarian, CO
10/21/2016 3:58:00 PM
What we got was lied to.R.R. - Republican, TX
10/20/2016 4:36:00 PM
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