APPENDIX C2: ACA POSITION PAPER – THE FALLACY OF FASO’S “REFORM AND FIX”

Not so fast, John Faso.
Lining up Congressman Faso’s statements with the facts:
Faso’s February 8, 2017 Op-Ed and Professor Skocpol’s Response

This appendix was posted February 27, 2017. Faso’s February 8, 2017, Op-Ed, “Reform and fix’ the Affordable Care Act, may be found here.

Below are Professor Theda Skocpol’s comments to us on review of the Faso Op-Ed:

“Here are a few comments on your Congressman’s OpEd, which hews pretty closely to standard GOP ideas:

  • 20 Million is on the low end, as coverage expanded for somewhere between 20 and 30 million; furthermore, all Medicare beneficiaries and all employer insured Americans got very important new benefits and protections, including free checkups and limits on insurers’ ability to limit lifetime benefits or cut sick people.
  • Fewer than expected did sign up on the exchanges for 2017, in part because the Trump administration and GOP talk of repeal discouraged the last minute surge; in addition, insurance companies affected by GOP steps in Congress to limit payments to them raised premiums in some states. In short, GOP sabotage efforts are part of the reason fewer than expected signed up.
  • Too few choices on the exchanges have happened in some states, especially in states where GOP governors and legislatures refused to expand Medicaid to the near poor. When that happened, some of these expensive people ended up in the exchanges. NY state has not had these problems. Its insurance market has gotten a lot better, and premium increases much lower, since ACA. But repeal would make the older problems return.
  • Costs both overall and to most families have gone down overall since ACA, despite some upward trends for 2016. Insurance premium costs were truly “skyrocketing” before ACA – and all existing GOP proposals would cause premiums for older and sicker people to do that again.
  • Problems faced by businesses and ideas about allowing business groups to purchase plans together could easily happen with modest ACA reforms. Democrats have been pushing such improvements, too, but the GOP Congress has refused to do them. Repeal is not necessary for small repairs.
  • State based risk pools would be a terrible deal for most Americans, tens of millions, with preexisting or serious health conditions. That has long been the GOP idea about what to do when insurance companies are allowed to avoid such people or charge them more – a situation that repeal would bring back. However, risk pools are never adequately funded to meet demand and current GOP repeal ideas would not provide anywhere near enough funding. The whole idea of health insurance is that everyone pays and gets affordable coverage when sick. Shunting the sick off into separate pools does not work.
  • Better funding for expanded and additional community health centers has flowed through ACA, and would disappear with repeal.

“What your Congressman is not acknowledging is that all GOP repeal plans are about slashing taxes on business and the wealthy that pay for tens of millions of more Americans to get affordable coverage. Limits in the existing system have to do with NOT ENOUGH MONEY to fully lower premiums and co-pays for middle class Americans. Americans tell pollsters they want more help, not less. But the GOP repeal ideas would simply give the wealthy huge tax breaks and make premiums less affordable, raise co-pays, and leave tens of millions without good or any coverage.”

Professor Skocpol is the Director of the Scholars Strategy Network (SSN) and Victor S. Thomas Professor of Government and Sociology, Harvard University. Skocpol’s research focuses, among other things, on health reform, social policy, and civic engagement amidst the shifting inequalities in American democracy. Current projects include tracking the implementation of health reform in the U.S. states and analyzing the dynamics of local Tea Party groups. More about Theda Skocpol and the SSN may be found here.

This work is licensed under a Creative Commons Attribution 4.0 International License. You may use and attribute this work only in accordance with the terms of this license. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/4.0/.