This morning in a comment on an MSNBC story about Republican plans to vote to repeal the Affordable Care Act, I wrote the following:
If the ACA is repealed, we'll be back to square 1:
45M Americans uninsured and 60M at any one time. Number increasing with high unemployment and as medical inflation forces businesses to drop coverage
15M Americans underinsured. Number increasing as medical inflation forces businesses to reduce benefits
Americans with pre-existing conditions cannot obtain health insurance
Americans with expensive conditions (often multiple conditions) reach cap limits and lose insurance
Americans with expensive conditions (often multiple conditions) lose their insurance through rescission
The Medicare doughnut hole is reopened
Increased pressure on EDs, raising costs for everyone and forcing closures (500 since 1990)
Investment to increase the number of primary care physicians (badly needed) is terminated
Incentives to create population-health based Affordable Care Organizations are terminated
Medicare financing in jeopardy because of aging population and a compromised tax base (the real income financing Medicare for the last 30 years has remained flat while medical inflation has increased at about 5% per year)
Three questions:
Is this a problem?
If it is a problem, how do you propose to address it in a bipartisan way? (Conservatives claim that the ACA is partisan legislation, so presumably their health care legislation will be bipartisan.)
Currently, about 9M people who could afford health insurance and who could pass a health screening have chosen not to purchase it. In light of the over 50M want to be insured but can't be, why is a mandate an overreach?
By tonight, I had received the following responses: