Republicans hate ObamaCare – not a single member of their party in Congress voted for it. Democrats love ObamaCare – they all voted for it! But how well do these parties understand ObamaCare?
John C. Goodman, healthcare economist writing for Independent.org, says neither party really understands ObamaCare’s problems. He tells us in the House of Representatives, the GOP’s “number-one priority for health care reform” is lowering health insurance premiums.
What Republicans are Missing
It is certainly true that premiums in the ObamaCare exchanges are sky-high. In fact, if you add together the average premium and the average deductible for a family of four, a family without any subsidy must pay more than $25,000 before it gets any benefit from their plan! That’s the equivalent of buying a Volkswagen Jetta every year just to get health care.
However, Goodman points out that the vast majority of folks who buy their own insurance are getting large subsidies. So much so, that 8 in 10 enrollees in the exchanges pay $10 a month or less. For a family with average income, the premium is usually zero. That means 80% of the voters who are on ObamaCare don’t care about premium prices.
What Democrats are Missing
The Democrats think ObamaCare is all about protecting people with expensive health care problems. By eliminating disqualifications for preexisting conditions, millions of Americans are benefiting from ObamaCare.
But Democrats don’t understand that the average annual out-of-pocket exposure for a family in 2024 is $18,900 in the federal marketplace exchanges. And if health care problems linger (which is the very definition of “chronic illness”), the family faces that expense every year. To make matters worse, medical centers of excellence around the country (which house specialists that some patients really need) won’t accept ObamaCare insurance.
Goodman says the brutal truth is that families with the worst medical problems and the most expensive medical needs would in many cases be better off if ObamaCare had never become law! While there were some instances where people with preexisting conditions before ObamaCare were denied coverage, there were also risk pools in most states where their out-of-pocket exposure was well below ObamaCare plans today – and you had access to most doctors and hospitals.
The ObamaCare Reality
I wrote a book by this name, but that’s besides the point. Here’s the reality of ObamaCare today that both parties are missing: Goodman says, “If you have to buy your own insurance, have average income and are healthy, your options have never been better. But if you have a chronic illness and high medical costs, your options have never been worse.”
The healthy family not only is paying little or no premium, but the only health care they need is preventive care, which must be made available at no charge. For this family, health care and health insurance are free.
By contrast, if you are sick, the out-of-pocket costs can be crushing; and even then, narrow networks may not include the specialty care you need. Further, in almost all cases, if a patient goes out of the network, the insurance plan pays nothing. In that case, getting the care you need is just as expensive as if you were completely uninsured!
Republicans need to stop focusing on high insurance premiums, since most people are not paying them. Democrats need to stop crowing about coverage of preexisting conditions and do something about the sky-high out-of-pocket exposure for less than healthy families. Even if you have generous employer-provided coverage, the problems of ObamaCare are just one layoff away from your new reality.
