Unless Congress finds a way to repeal the Affordable Care Act during the next 10 months — after more than 60 failed attempts — President Barack Obama will leave office with his signature legislation intact, and running pretty smoothly. ADVERTISING
Unless Congress finds a way to repeal the Affordable Care Act during the next 10 months — after more than 60 failed attempts — President Barack Obama will leave office with his signature legislation intact, and running pretty smoothly.
Obamacare, which turned 6 this week, has reduced the share of Americans without health insurance by half, provided people without job-based coverage access to affordable high-quality options and prevented people from being denied insurance because of pre-existing health conditions. Meanwhile, health care costs have grown more slowly than they did before the law was passed.
Yet, the ACA should by no means be the end of health care reform — not least because it leaves 11.5 percent of adults under 65 uninsured. Greater efforts are needed to make sure everyone who qualifies for government subsidies to buy insurance knows they do. And the 19 states that still refuse to expand Medicaid to more residents need to get with the program.
Efforts are needed to lower the increasingly crippling costs of copayments, deductibles and other expenses. In the past decade, the average deductible more than doubled, to $1,318. Among Americans who now have insurance, one in five say they struggle to pay medical bills.
One good suggestion is Hillary Clinton’s proposal to allow patients three annual visits to a doctor before deductibles kick in. Clinton’s refundable tax credit for out-of-pocket costs could help, too.
Another fundamental problem with the U.S. health care system is the trajectory of total spending. From 2014 to 2024, it’s expected to grow 1.1 percent faster than the economy as a whole, reaching 19.6 percent of gross domestic product.
In years to come, policymakers, voters and the next president will need to expand the goals of health care reform. It’s essential, for example, to shrink persistent health disparities by income and geography; to stem rising death rates among middle-age whites; and to reduce suicide, opioid addiction and infant mortality. Ultimately, the U.S. health care system should go beyond making sure Americans have insurance cards, and see that they live in the best possible health.
— Bloomberg View
