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Dec. 11, 2019

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In Our View: Affordable Care Act must be bolstered, protected

The Columbian
Published: November 1, 2019, 6:03am

Despite persistent efforts by the Trump administration to undermine it, the Affordable Care Act is relatively stable in Washington.

With the enrollment period open until Dec. 15 — and with health insurance being a key topic heading toward the 2020 election — it seems a good time to reassess how the law is working here and throughout the country.

About 200,000 Washington residents signed up for health insurance through the Washington Health Benefit Exchange for 2019. For the coming year, state insurance commissioner Mike Kreidler has approved an average cost decrease of 3.25 percent on the individual market. In Clark County, several different companies and coverage options are available through the state’s website.

The most notable number, however, is that one year ago, Washington’s uninsured rate was 5.5 percent. That marks a sharp decline from the 14 percent who were uninsured before the state implemented the Affordable Care Act — colloquially known as Obamacare — in 2014.

“Despite the Trump administration’s effort over the last two years to sabotage the Affordable Care Act, the record average rate decrease and interest by insurers is evidence that our market is stabilizing,” Kreidler said in a news release. “We have more work to do to lower the cost of health care and to help lower out-of-pocket costs, but more choice and lower premiums are welcome news.”

Indeed. Expanded coverage improves the health of our communities, increases preventive care that in the long run reduces costs, and improves the quality of life for hundreds of thousands of Washingtonians.

Still, the Affordable Care Act remains under attack. The 2017 Republican tax overhaul eliminated the individual mandate that imposed a tax on uninsured Americans, destabilizing the market. The removal of that provision led a Texas trial judge to declare the law unconstitutional last year; a circuit court decision on an appeal is expected soon, and it is likely that Obamacare will end up in front of the U.S. Supreme Court for a third time.

In addition, the administration has removed some cost-sharing subsidies to insurers; has allowed the return of narrow coverage plans; and has significantly reduced the marketing budget to inform the public about health care options.

Trump was elected after promising to repeal and replace Obamacare. But with Republicans controlling Congress during the first two years of his presidency, those efforts failed. Since then, the administration has attempted the “death by a thousand cuts” approach. Nicholas Bagley, a University of Michigan professor, told NPR that the law “has been battered. It has been bruised. But it is still very much alive.”

That is good news for many Washingtonians. In 2021, the state is planning to roll out a Cascade Care plan that will make it the first to offer a public health option and standardized coverage benefits.

Meanwhile, the race for the Democratic presidential nomination has brought forth various proposals and much discussion about “Medicare-for-All.” Considering that a majority of Americans are pleased with coverage provided through their employers, it seems unlikely that a federal takeover of the system will gain much traction with the public or in Congress.

Instead, Democrats should focus on protecting and bolstering the Affordable Care Act and working to ensure that all Americans have reasonable access to coverage. Nearing the 10th anniversary of its passage, the law is still gaining a foothold while avoiding attempts to trip it up.

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