Political content in this post. So have a Ferrari 250 GT Berlinetta Lusso!

Whatever your personal feelings on Obamacare, the reality is, it’s now going to be with us for a while longer. We can either work on ways to improve coverage for people, or not.

Here are a couple of articles that are interesting.

First off, the Kansas state legislature just voted to expand Medicaid. Their governor has threatened to veto it, but maybe he won’t.


For those of you unfamiliar with Medicaid, each state runs an insurance program for low-income people, and is reimbursed on a per-person basis by the federal government.


Obamacare did two things to get more people covered by health insurance:

  1. Created marketplaces in which individuals could buy plans from private insurance companies at reduced rates, with lower-income individuals able to get subsidies applied directly to their out-of-pocket premium costs.
  2. Provided the ability for states to raise the bar for how much money people can make and still qualify for Medicaid programs, the cost of which the federal government would cover, for the most part (eventually after a few years the federal government would cover 90% of costs of the expansion). Many, but not all, states expanded Medicaid. In states that did not expand medicaid, there are people who make too much money to get Medicaid, but not enough money to get the subsidized rates in the health insurance exchanges.


Now that the AHCA is dead in the water and the Republicans have no other immediate fix in the works, several states, even particularly red ones, are starting to say, “hey, maybe we should take that federal money to expand Medicaid.”


Here’s another whopper for you: Republicans often cite the large, and increasing, deductibles and other out-of-pocket costs that people get stuck with in plans they purchase through the health insurance exchanges. Section 1402 of the Affordable Care Act is supposed to provide for a bunch of waivers for these costs, but...

The provision lays out a set of formulas that, in essence, requires insurance companies to waive some of the deductibles and other co-payments for lower-income families. Under 1402, the government is required to reimburse insurers for the cost of these waivers. About 7 million Americans benefit.

However, in 2014, Republicans in the House of Representatives sued the Obama administration, claiming that because Congress had not specifically appropriated this reimbursement money, the government could not dispense it. In May 2016, U.S. District Judge Rosemary Collyer (a George W. Bush appointee) enjoined Health and Human Services from continuing the payments.

The Obama administration, of course, appealed the ruling. But the case is on hold — and the funds remain frozen — pending a decision by the Trump administration on whether to proceed with the appeal.


That’s right, Republicans in the House of Representatives are the reason why those 7 million people’s out-of-pocket costs are out of control.

Another problem with the exchanges that the Republicans like to point out is that in many areas, health insurers have left the exchanges because they haven’t been making money selling plans in them, and people are left with maybe 1 or 2 insurers to choose from. Well guess what? This is also their fault!

Section 1342 promised to reimburse insurers who experienced extraordinary losses in the early years of the exchanges, when predictions about costs and revenue had to be made with no history to draw on. This program, called “risk corridors,” was derailed by a provision that Sen. Marco Rubio (R-Fla.) slipped into a broader spending bill in 2015. That, too, has caused insurers to flee.


Personally, I hate health insurance companies, but the reality is, we need to structure our healthcare laws to encourage the health insurance companies to behave in a way that benefits as many people as possible.

The fact is, the original language of the Affordable Care Act did things to try and stabilize the problems that exist now, and those problems exist because Republicans have invalidated those parts of the ACA.


If they want to fix those problems, all they have to do is reverse their earlier actions, un-block those parts of the ACA, and let the law do what it tried to in the first place.