Muftic: Obamacare is ambulatory again
On a decisive 6-3 vote, the U.S. Supreme Court ruled that the legislation implementing Obamacare was constitutional and legislators intended that federally administered insurance could be subsidized.
What this means for consumers is that 6 million subscribers through the federal system will maintain their affordable health insurance and that for everyone else, the rates would not soar. The subscribers most affected were those who lived in the 35 states that did not set up their own health insurance exchanges through which Obamacare could have been administered on a state basis.
Kaiser Health had predicted that all insurance rates would have increased eventually more than predicted otherwise if the Court did not uphold the Obamacare law. The Congressional Budget Office also predicted a hit in the long term to the deficit if the law was overturned because indeed there were cost savings built into Obamacare to the health care system that aided the flattening of the cost curve. Costs were held down by less charity care, greater, more transparent competition, and no co-pay preventative care.
With fewer consumers unable to pay their bills and with more consumers getting preventative care and checkups without copays, the entire system would see lower costs than if the Obamacare system were not viable.
Colorado would not have been immediately affected since Colorado was one of the states that set up the state exchange. But in the future, the lack of participation of so many in health insurance in general would have set up conditions that might have made Obamacare financially unsustainable since the whole system depended upon a large number of healthy as well as sick making the pool of insurers large enough to attract even healthy payers.
Our own state health exchange has also come under fire for administrative and financial problems and there is talk of abandoning the state exchange and moving its customers to the federal exchange if the Court ruled in favor of Obamacare. There is now a plan B, a fallback to the federal exchange, if the state exchange is put on ice by the Colorado Legislature.
Politically both Democrats and the GOP can breathe a sigh of relief. The Obama health care legacy is secure. The GOP would not have to face 6 million hardship stories on media of those who had to drop insurance. After five years of trying, Republicans have never come up with a comparable replacement. Nonetheless, diehards in Congress are still vowing to repeal Obamacare. Others are proposing tweaks.
One of their “fixes” is a Trojan horse that would eventually destroy the ACA, to remove the individual mandate (already upheld by the Court) and mandates on employers to provide insurance. This would have eventually destroyed the system since mostly the sick would have subscribed, the pool would have had less healthy paying to cover the sicker, and the cost would have spiraled into its eventual death.
State legislatures are also off the hook. Most of the states not having state run exchanges are red states, so they have avoided a painful dilemma, choosing between setting up their own exchanges, or depriving numbers of constituents of their newly acquired insurance.
For sources tapped for this column, visit http://www.mufticforumblog.blogspot.com.
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