Even in a solid blue state like New York, a repeal of the Affordable Care Act (ACA) has merit, at least that’s what many Capital Region residents say. Just days before President-elect Donald J. Trump is set to take the oath of office, a CDPHP® Insights survey found that a majority of health care consumers (55 percent) support a repeal of the ACA. Of those who want to do away with it, 80 percent want to see plans to replace it first.
Trump and the Republican-controlled Congress have already begun the process of dismantling the ACA, but the question of what’s next remains. Just as with the uncertainty of Mr. Trump’s election, many questions are still unanswered when it comes to the future of health care in America. And many states’ governments, including ours, are concerned about the federal funds being pulled and consumers losing coverage.
The ACA was passed in 2010 with two main goals: increase access and improve affordability. No one can argue that more Americans have insurance since the law took effect, but most would agree that the law was unsuccessful in addressing the affordability epidemic. In fact, just 5 percent of CDPHP Insights respondents said they were able to afford health insurance as a result of the law. Instead, the vast majority (95 percent) said their health care costs either went up or were unchanged in the wake of the law.
As the CEO of a not-for-profit health plan, I can tell you that the ACA – despite improving health insurance access across the country — included a copious number of taxes, fees, and other mandates, which added significant cost to the system. Speaking solely on the issue of taxes, CDPHP alone pays $93 million a year in state and federal taxes, and $33 million of that is directly related to the ACA. Sadly, consumers like yourself are being forced to foot those bills through higher insurance premiums and changes to benefits.
As the new administration prepares to settle into the White House, I would like to add my two cents, a wish list of sorts, for the future of health reform:
- Provide consumers, health plans, and state government with a reasonable transition period to effectively implement a replacement plan
- Provide health plans with flexibility to create innovative benefits that meets consumers’ needs and wants
- Provide limited enrollment periods, perhaps similar to Medicare Advantage
- Encourage consumers to have continuous coverage to promote healthy risk pools
- Provide continued coverage for adult children up to age 26
- Provide continued coverage of pre-existing conditions
The fact of the matter is that the ACA has not completely lived up to its promise, and most consumers know it. While the days, weeks, and months ahead are sure to be unpredictable, I am hopeful that – if we work together – we can get it right this time around.