Actually, he has done no such thing. Opposition to the ACA may be Senator Cruz’s signature issue. His willingness to bring the federal government to a grinding halt in order to grandstand on the issue earned him a lot of notoriety. But when it comes to “replace,” the candidate remains vague at best. The reason probably has to do with the fact that an alternative along the broad lines that Senator Cruz has supported—inter-state sale of insurance, increased use of Health Savings Accounts—would cause millions of people to lose their coverage. It would also reintroduce discriminatory practices that have been outlawed by the ACA and impose large financial losses on families and on the health care industry, which has lately been one of the main engines of employment growth since the recession . That’s not a very attractive policy platform. Meanwhile, fellow candidate John Kasich offered implicit criticism of his opponent’s greatest claim to fame, calling efforts to repeal the ACA while President Obama was still in office “a big joke” and promises to do so “stupid.” (No fooling.)
Discriminators Gonna Discriminate
At the same time, the insurance industry has not turned over a new leaf and embraced the ACA’s rule prohibiting discrimination against sick people. In the past they have used practices such as placing all HIV medications on the most expensive cost-sharing tier to try to discourage sick people from enrolling. More recently, many insurers have adopted the practice of manipulating insurance broker commissions to discourage sales to people who might have higher medical claims. The takeaway is that while the ACA creates the opportunity to eliminate discriminatory industry practices, vigilance and aggressive enforcement continue to be necessary to make that promise a reality.
More On The Insurance Industry Front: How Much Did It Cost To Produce That Report?
This week the Blue Cross Association issued a report with the surprising finding that if you stop discriminating against sick people in the sale of insurance, then more sick people will get coverage. While ACA opponents will no doubt find fuel for fresh attacks in the report’s findings, most observers consider the results unremarkable. If anything, the surprise is that premiums have been lower than most forecasters originally projected.
Another week, another example of drug companies preying on sick people by raising the price of an already existing medicine. While there can be no doubt that there is still a long slog ahead, the pressure to do something about drug companies’ abuse of their monopoly power is growing. Most recently, the American College of Physicians issued a call to rein in drug prices including endorsements of measures such as allowing reimportation, federal drug price negotiation and requiring manufacturers to be transparent about research, marketing and production costs.
And for some good news…
The New Hampshire Senate joined their colleagues in the House to retain full coverage of low-income adults in that state preserving coverage for 48,000 people. In Florida, legislators sent a bill to Governor Scott providing protections for consumers against surprise medical bills. Let’s hope Scott signs the bill (or allows it to become law) and that success in Florida motivates other states to act as well.