Open enrollment for insurance plans under the Affordable Care Act (the proper name for Obamacare) began Tuesday, and the big news has been that premiums for some of the popular plans are going up by an average of 25 percent.
Republicans -- who have been trying to repeal the Affordable Care Act for its entire existence -- promptly harped on this fact to prove that The System is Broken. Donald Trump and Mike Pence both pledged this week to “repeal and replace” Obamacare.
Just one problem or two. The premium increases aren’t quite as bad as we thought.
First off, the premium hikes apply only to the 7 percent of Americans who get their health insurance through one of the Affordable Care Act exchanges. If you get your health insurance through your employer, through Medicare or Medicaid, you’re not affected.
Second, the burden of the increases will be softened by various subsidies. Of that 7 percent -- or about 10 million people -- 85 percent are eligible for one subsidy or another. These subsidies are often big enough to cancel out the premium increases; in many cases, customers will actually wind up paying less.
That leaves about 1 million Americans who are getting stung -- bad, but it could be worse.
Third, many health-care experts believe the double-digit increase is a one-time thing, a painful correction. It may not happen again.
Which isn’t to say Obamacare is trouble-free. It isn’t. The basic problem is, people don’t want health insurance unless they're sick.
We decided that we don’t want a health-care system like Canada’s, where everyone is signed up whether they like it or not, and everyone has to pay. Obamacare is an opt-in system; if you don’t want it, and don’t have alternative insurance, you have to pay a fine or fee.
What’s happened is, too many sick people are signing up for Obamacare. Too many young, healthy people don’t think they need it, and they opt to pay the fine.
Obamacare is not “socialized” medicine. It ultimately relies on private insurance companies -- and private insurers rely on the vast majority of their customers not putting in big claims. Without enough healthy clients, some companies have been losing money on the health-care exchanges.
The ACA is better than the non-system we had before, when millions of working Americans had no health insurance. They let health problems slide until they landed in the emergency room, costing us all money. There's abundant evidence that Obamacare and Medicaid expansion have eased inflation in the private health care market, so that all of us are paying less.
Republicans, meanwhile, remain disturbingly vague about what they'd replace Obamacare with.
Until they come up with something more detailed, it seems much wiser to stick with the devil we know.
