President Trump unabashedly tries to create his own reality, urging Americans to ignore facts and even their life experience. When it comes to their health care, however, he’s having only minimal success convincing Americans that he has already destroyed Obamacare.
The Kaiser Family Foundation’s latest poll tells us: “About one-fifth of non-group enrollees (19 percent) are aware the [Affordable Care Act] mandate penalty has been repealed but is still in effect for this year. Regardless of the lack of awareness, nine in ten non-group enrollees say they intend to continue to buy their own insurance even with the repeal of the individual mandate. About one-third (34 percent) say the mandate was a ‘major reason’ why they chose to buy insurance.”
That, in large part, is because they are generally satisfied with the coverage they are buying on the exchanges:
Nearly equal shares of marketplace enrollees say their coverage is an “excellent” or “good” value as say it is a “fair” or “poor” value. About half of marketplace enrollees (51 percent) say their coverage is an “excellent” (20 percent) or “good” value (31 percent) for what they pay for it, while 48 percent say it is a “fair” (28 percent) or “poor” value (20 percent). This is similar to the results in 2016 and appears to halt the increase in the share who said their health insurance was a “fair” or “poor” value as reported two years ago. . . .
Most marketplace enrollees, who also were in the non-group market in 2017, say their health insurance premiums are either “lower” this year or “about the same” as they were in 2017. One-third (34 percent) say their premiums are “about the same” this year compared to last year while one-fourth (23 percent) say they experienced a decrease in their premiums this year. This may be because many marketplace enrollees receive financial assistance through premium tax credits to help cover the cost of their premiums, which protects them from being directly impacted by premium increases. About four in ten (42 percent) marketplace enrollees say their health insurance premiums are higher this year compared to last year, including one-fourth who say their premiums are “a lot higher” and 17 percent who say they are “a little bit higher.”
In other words, Trump and the GOP succeeded in raising the burden on taxpayers. Moreover, health-care coverage is perceived as a necessity by the vast majority of Americans — 91 percent in the employer-sponsored insurance market, 84 percent of non-group enrollees, 88 percent of ACA marketplace enrollees and 71 percent of uninsureds adults (71 percent) say having healthcare insurance is “very important.”
However, given the political debate, most Americans are convinced that the exchanges are collapsing and worry about coverage in the future:
Half of non-group enrollees and six in ten marketplace enrollees say they are worried about the potential for lack of health insurance coverage in their areas. Half of non-group enrollees (51 percent) and six in ten marketplace enrollees (58 percent) say they are “very worried” or “somewhat worried” there will be no insurance companies left selling plan in their area in the future, similar to the share who say they worry that their own current insurance company will stop selling plans in their area (49 percent and 58 percent, respectively).
So what’s the bottom line here? It seems that Trump has not destroyed the Affordable Care Act, as he claimed, but he has made most Americans (who overwhelming think they really need it) anxious about future coverage. In other words, he has increased people’s anxiety about a basic necessity in their lives. Not exactly a crowning achievement, is it?
It seems that there is an opening here for middle-of-the-road Democrats who understand the cost and difficulty of a single-payer system. They should offer Americans some peace of mind and tout the stability of the existing system. Trump creates unease and confusion; Democrats can back continued cost-sharing reductions (which Congress never passed, despite assurances given to Republican Sen. Susan Collins of Maine and others) to stabilize the exchanges and hopefully keep coverage costs from skyrocketing. They also can declare they support state re-insurance plans that cover the sickest people (at great expense), thereby reducing the cost of covering everyone else who remains in the plan.
Ultimately, there is a deal to be made here: Medicaid extension to all states in exchange for more state flexibility, while bolstering the exchanges. That sort of common-sense solution, however, would need a constructive — and in all likelihood, Democratic — president, or a Republican from the ranks of governors who have advocated for compromise on the ACA.