Affordable Healthcare Act not so affordable

(Note: I sent this letter to the editor of the Greenville News on April 7, 2016. Since it's been so long, I've decided to self-publish--because I can--the letter myself.)

I must take exception to the op-ed in the Thursday, March 31, edition of the paper where Pamela Roshell, Region IV director for the federal Department of Health and Human Services, provided a one-sided view of the Affordable Healthcare Act (ACA). She stated, “Virtually every American has benefited in some way from the ACA, whether they realize it or not.” Take a look at some of the most recently released data and decide for yourself:

• By the end of 2015, nearly one third (30+%) of innovative health insurance plans created under the ACA are out of business. Many of the companies providing coverage are also leaving the marketplace in many states (UnitedHealth, Humana, Blue Cross Blue Shield, Aetna). This directly impacts cost and opportunity to find competitive pricing for insurance.
• The National Association of Insurance Commissioners, as reported by the Washington Post, indicate that more than 50% of the co-ops are in financial trouble.
• In 2014 (most recent information available), more than 214,000 doctors (25% of the total number of active professionals are reported by the Kaiser Foundation) opted out of the ACA exchanges, leaving many patients without care or access to affordable care.
• While nine million more people do have insurance, there are still 33 million Americans (mostly poor) who do not have any coverage. The Kaiser Foundation reports that the 48% of the uninsured opt out because they can't afford premiums.
• The uninsured still burden the emergency rooms (ERs) of hospitals, who are forced by the ACA to treat patients. In May 2015, USA Today reported that 75% of ER physicians have seen surges in patient visits since the ACA was enacted—the opposite of the law's intentions. Some of this is due to habit, and some is due to lack of access to primary care physicians, but it is still an issue.
• In October 2014, the National Bureau of Economic Research issued a report through the Brookings Institution that showed premiums in the market (those who wanted to “keep their health plan”) grew by 24.4% compared to what they would have been without the ACA. And, that the premiums rose in all but six states.
• In October 2015, Bloomberg reported that rising premiums for ACA coverage (the government's plans) increased anywhere from 10 to 25 percent. In several states where first year pricing was mismanaged, premiums decreased.
• In Feb. 2015, CNN reported that deductibles, co-payments and drug payments are higher under the average ACA silver-level plans -- the most popular -- than employer policies. That was echoed by Forbes magazine in December 2015. The Obama administration claimed, Forbes reported, that the ACA has provided more people with health insurance, and slowed the growth rate of health spending. The facts, as reported by the Obama administration's Centers for Medicare and Medicaid Services (CMS): All of the disruption, spending, taxation, and premium hikes in the ACA has reduced the percentage of U.S. residents without health insurance by a mere 2.7 percentage points.
• The economists at CMS went on to report in Health Affairs that the growth of national health spending in 2014 was 5.3%, the highest rate since 2007. Their own analysis: “The return to faster growth was largely influenced by the coverage expansions of the Affordable Care Act.”
• In 2014, U.S. government spending on health care neared $1.4 trillion. That cost is more than $4,500 for every man, woman and child in the country; far more than needed to achieve universal coverage in a rational, market-based system.

And now, to the bottom line that everyone remembers. Contrary to the popular statement by the president, “If you like your plan, you can keep your plan,” those that were able to keep their plans (like myself), were only able to do so at a much higher cost. I choose to keep my coverage because of the unreasonable, and costly, prescription drug co-pays within the ACA. (For the Silver plan, co-pays are $13 for generic, $47 for preferred brand and $89 for non-preferred brand. Mine are $5, $25 and $35.) Added to that, the premiums for the ACA plan comparable to my own plan were about $10 a month less expensive, but the out-of-pockets expenses and co-payments were so much higher, I would have spent more than an additional $3,000 by going with the ACA. And that's after taking into account the higher premiums paid for the non-government insurance.

The president also claimed that the ACA will “lower premiums by up to $2,500 for a typical family per year.” I don't know about you, but that has not happened for me. In fact, my costs are higher, and premiums continue to increase in low double-digits every year (from 10-12 percent.)

The 2015 Forbes article summarizes the entire healthcare law debacle best: “It is harder and harder for champions of Obamacare to ignore the plain truth that this misguided law has increased premiums, a burden borne by millions who have to buy coverage in that market without the benefit of taxpayer subsidies and by the taxpayers who must bankroll subsidies for those who qualify.”

I believe our healthcare system needs a huge overhaul—from top to bottom. But the ACA as it is currently enacted is not the solution. For Roshell to just blindly tout the one-sided party line that everyone has benefitted from the ACA is inaccurate and misleading. For those who have benefitted from the law, I'm delighted. I hope it continues to help those in most need. However, for the middle class that continually gets squeezed in entitlement programs, the ACA just isn't working.