Opinion - Politics

Republicans and 'Medicare for All' Democrats should stop sabotaging Obamacare, Delaware senator says

Sen. Tom Carper (D-DE)
Key Points
  • As health care open enrollment begins, there is growing evidence that the Affordable Care Act is working, and it is imperative that we build on its success – not tear it down.
  • Since day one, Republicans have done their dead level best to undercut the ACA at almost every turn.
  • Just as we're starting to see premiums decrease and health plan choices increase in a number of state exchanges, I'm at a complete loss as to why so many of my colleagues remain hell-bent on scrapping the ACA – whether through the Texas v. United States lawsuit or a complete overhaul like Medicare-for-All.
Supporters of the Affordable Care Act participate in a "Save Obamacare" rally in Los Angeles, California on March 23, 2017.
Ronen Tivony | NurPhoto | Getty Images

When it comes to crafting effective policies for our country, I believe that we should find out what works and do more of that. As health care open enrollment begins, there is growing evidence that the Affordable Care Act is working, and it is imperative that we build on its success – not tear it down.

Since day one, Republicans have done their dead level best to undercut the ACA at almost every turn.

On March 23, 2010, the ACA was signed into law – marking a historic moment for our country. We were finally on our way to providing millions of American families access to quality, affordable health insurance.

On that same day in 2010, 14 Republican Attorneys General challenged in court the ACA's requirement that Americans buy insurance – a concept first put forth by Republican Senator Lincoln Chafee and implemented in Massachusetts by then-Governor Mitt Romney in 2006. This cynical move would mark the beginning of their years-long effort to undercut the law.

Four years later, the ACA health insurance marketplaces were up and running, covering millions of Americans, many of whom, for years, could not afford insurance and, as a result, could not access much-needed health care services. Health insurers had to gain footholds in these new marketplaces. Just like turning an aircraft carrier, we knew that ensuring competition and stability would take time.

Both Democrats and Republicans, though, knew that there could be steps taken at the federal level to create predictability for insurers, help stabilize the marketplace, increase competition and bring down premiums. Instead, Republicans did the opposite and deliberately cut payments intended to stabilize premiums.

Then, in 2016, just as independent market analysts such as Standard & Poor's began to project improvements to the marketplace, Republicans eliminated subsidies that help lower deductibles and co-payments for consumers – a move that would send premiums up by double digits yet again.

Republicans were like Lucy with the football, and patients across the country were left hurting like Charlie Brown.

Today, these efforts continue. Now, the Trump Administration and 18 Republican Attorneys General have gone so far to embrace a lawsuit to scrap the ACA in its entirety.

As it turns out, the ACA is more popular now than ever. More than 20 million Americans have gained health care coverage through the law. Nearly 130 million Americans living with pre-existing conditions have critical protections they didn't have before.

Still, though, despite Republicans' best efforts to sabotage the law, we have seen that when we let the ACA work, it actually does. But you don't have to take my word for it.

As we kick off the 2020 open enrollment period, 43 new insurers will be offering coverage in marketplaces of states around the country in the coming year. That gain comes on top of the 23 new insurers that were added in 2019.

And as competition increases in the ACA marketplaces, premiums have begun to stabilize. Some are even decreasing. Next year, premiums for the most popular ACA plans across America are set to drop by 4 percent. Even more encouraging, multiple states will see average premiums come down by double digits in their exchanges next year.

Delaware is one of them. After rising by double digits for several years, the average increase in premiums in Delaware's marketplace slowed to 3 percent in 2019. Beginning this January, though, average premiums will drop by a whopping 19 percent in the First State.

Why? In large part because, earlier this year, Delaware announced it would be introducing a reinsurance program designed to help insurers pay for some of their costliest patients. That, in turn, will help keep premiums down for everyone else in the state's marketplace.

Delaware is not alone. Other states like Maryland, Colorado and Montana have implemented similar reinsurance programs this year and will also be seeing significant premium reductions for 2020.

As a former state treasurer and governor, I can recognize an encouraging trend when I see one. Well, one is beginning to emerge and, just as we're starting to see premiums decrease and health plan choices increase in a number of state exchanges, I'm at a complete loss as to why so many of my colleagues remain hell-bent on scrapping the ACA – whether through the Texas v. United States lawsuit or a complete overhaul like Medicare-for-All.

As it turns out, the ACA is more popular now than ever. More than 20 million Americans have gained health care coverage through the law. Nearly 130 million Americans living with pre-existing conditions have critical protections they didn't have before. The law has expanded Medicaid coverage for 12.6 million more Americans and extended the life of the Medicare Trust Fund by 11 years. And this progress was made all while reducing the federal deficit by more than $1 trillion.

Is the ACA perfect? Certainly not. No law is. And Congress has, for a decade now, been unable to make needed fixes. Am I saying our work to bring down health care costs is done? No. In fact, just the opposite.

Just as Rome wasn't built in a day, the transformational reform of our health care system wasn't perfectly implemented in a few short years. The ACA was a historic step forward. States, like Delaware, are building on the foundation it laid, and consumers are seeing the benefits as a result.

Imagine where our nation's health care system could be today if we had spent the last decade implementing the ACA as intended and making common sense improvements to it rather than deliberately sabotaging it! Let's finally put patients before politics and make the common sense improvements to continue to lower health care costs for the American people.

Tom Carper is the senior senator from Delaware.

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