An ardent supporter of President Obama’s health law now admits the funding for the law is in peril because young Americans simply aren’t signing up in large enough numbers and a health policy expert says Republicans are on the right track with their various repeal and replace approaches to the law.
In an effort to get everyone insured, the health care law has always been predicated upon millions of young, healthy people choosing to enroll, even though the penalty for not having insurance is far lower than the premiums they are facing.
The Obama administration now says more than three million people are enrolled in the various health care exchanges but won’t offer statistics on how many have actually paid premiums and whether enough young people are in the mix to pay for the care needed by older, less healthy Americans.
Virginia Rep. Jim Moran told NPR-affiliated WAMU radio that he doesn’t expect the numbers to balance when open enrollment comes to a close.
“I’m afraid the millenials, if you will, are less likely to sign up. I think they feel more independent. I think they feel a little more invulnerable than prior generations but I don’t think we’re going to get enough young people signing up to make this bill work as it was intended to financially,” said Moran.
Galen Institute President Grace-Marie Turner says Moran’s fears are well-founded.
“All of the indications say that young people are not signing up at the level that we expected. I suspect the president’s probably going to have a couple of young people in the First Lady’s box at the State of the Union speech tomorrow night, saying that young people should be signing up. They really need to encourage them. It’s not happening,” said Turner.
“The reason is that the incentives are all wrong. They’re charging them more for policies that are much richer than they want. Many of them don’t even have jobs, for crying out loud, because of the Obama economy. I think it’s very very unlikely you’re going to see the young people and therefore it’s even more unlikely that this Obamacare plan, and certainly the exchanges, become even more unstable than they already are,” she said.
Moran’s comments come a day before Obama’s State of the Union message and on the same day three prominent GOP senators unveiled their plan to repeal Obamacare and replace it with a market-based system that still protects Americans with pre-existing conditions and allows children to stay on their parents’s health plans to age 26 but open up competition and risk pools to drive down costs and promote tax credit. to help Americans afford their coverage
Sponsored by Sens. Orrin Hatch (R-Utah), Tom Coburn (R-Oklahoma) and Richard Burr (R-North Carolina), the bill would also include Health Opportunity Accounts for Medicaid patients, malpractice reforms to drive down the lost of liability insurance for doctors and transparency so patients would know how much individual treatments cost.
Turner says much like House bills drafted by Georgia Rep. Tom Price and the Republican Study Committee, this legislation heads in the right direction in many ways.
“They’d start by repealing Obamacare. They all provide subsidies for people to purchase health insurance if they’re middle income and lower income. They all would create a true market. They all want to reform Medicare and Medicaid in a true 21st century consumer choice model. If you do side-by-sides, you’d see a lot of similar check marks on each one of them,” said Turner.
Turner expects the House to pass major reforms later this year but that they will die in the Democratically-controlled Senate. She says if the GOP manages to win back the Senate in the midterm elections, major changes would be passed out of both chambers. Turner says Obama would never sign a repeal of his signature domestic legislation but the difficult realities of Obamacare could force him to accept major changes next year.
But before Republicans launch their legislative effort, Turner is offering two significant pieces of advice. First, she says, is to make sure the American people understand the differences between what Obamacare is doing and what GOP reforms would do.
“I think what Republicans have to do is explain what their vision is. What would they do differently than Obamacare and why should the American people say, ‘OK, we’re ready to go with you all.’ Don’t get into all the details of all the hard wiring and the nuances of legislation because that’ll confuse the American people even more than they’re already confused,” said Turner.
“Talk about this vision of consumer choice and portability. You get to decide what your plan is, not disrupting the employer market, allowing people who have coverage through small businesses to either get coverage on their own or continue to get it through their small business plan, but to give them the same tax break whatever they do. Those are all really important principles and people need to understand that,” said Turner.
She also endorses the House GOP approach of taking on the reforms one at a time rather than trying to make all the changes at once, noting it would just as foolhardy for Republicans to get behind one mammoth piece of legislation as it was for Democrats when they passed Obamacare in the first place.