Even while Donald Trump and Mitch McConnell plot to stack the Supreme Court to kill it, the Affordable Care Act and its individual insurance market carry on and even improve, making it a better deal for people with every year. That could be one of the reasons it's achieved and kept majority support with voters. It's so popular, the latest Kaiser Family Foundation health tracking poll finds the 60% of voters don't want the law overturned up 10 percentage points from one year ago. What's more, "a large majority of the public—including majorities of Democrats (91%), independents (81%), and Republicans (66%), now say they do not want to see the Supreme Court overturn the ACA's pre-existing condition protections."
The protections that the law has given everyone, including people in group and employer sponsored plans, are now baked into people's expectations and assumptions about health insurance. That's hugely motivating for voters this year, as it was in 2018. Obamacare isn't scary anymore. It's worked and people can see that. Even after nearly four years of concerted sabotage from within by Trump, it works. If the Supreme Court doesn't destroy it, it will work even better for people next year.
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Trump's own administration reports that "premiums for benchmark Affordable Care Act exchange plans will decrease in 2021 for the third year in a row, and most shoppers will have more plan choices." The cost of the benchmark plan will drop about 2% next year. For an individual 27-year-old, the monthly premium would be $369 before subsidies, and for a family of four, $1,486 before subsidies, on average. There will be 181 insurers selling plans on Healthcare.gov when open enrollment starts on November 1, compared to 175 last year.
The savings will be a lot more in four states—Iowa, Maine, New Hampshire and Wyoming, which will all see double-digit percentage decreases in premiums. In Iowa, for example, people buying the benchmark plan will see a 29% decrease in premium costs from last year. And only 9% of counties, nationwide, will have just one insurer on the market, down from 24% in 2020. "More than three-quarters of HealthCare.gov enrollees will have access to at least three issuers in 2021," CMS said in a statement.
It's an imperfect system for providing universal access to care by any measure, but it has worked to make healthcare affordable and available to more than 20 million people who otherwise would have been uninsured. It's made more than 100 million people with existing health issues insurable. The fact that insurance companies have bought in to the extent that they have and that the whole system has remained not just stable, but has gotten better even in the face of all the Trump sabotage, demonstrates just how much is at stake in this election. Without a Democratic Congress and White House in position to react if the Supreme Court does its worst, the nation's whole healthcare system will be thrown into disarray while the pandemic still rages.