My Obamacare Story

A much longer than tweet-length post.  Trump would be incapable of reading it.  Maybe you'll slog through it.
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Over the past month or so, I've received requests from several organizations to "share my Obamacare story."  So I will.  I'll share it with you, and also with my U.S. Rep. Pat Tiberi, House Speaker Paul Ryan, and my U.S. Sen. Rob Portman, Republicans all.  And I'll share it with Sherrod Brown, my Democratic Senator.

Obamacare must be preserved, strengthened and expanded, not killed.  It was invented for people like me and my family.  To fully understand why, start with the days before Obamacare.

For thirty years, I've had my own very small company.  (How small?  One person -- me.)  Over that time, when my wife held a job, we purchased health insurance through her employer's group policy.  When she was periodically unemployed, we had to buy individual health coverage which was always substantially more expensive for us and less comprehensive than any employer group plan.  But unless we wanted to go without any insurance whatsoever, we had no other option.

In addition to being basic yet pricey, individual health policies in those days were fond of excluding pre-existing conditions.  We encountered it twice in the years before Obamacare.

In the late 1980's, my wife went through a number of infertility treatments.  They were covered by her employer's plan, but were ultimately unsuccessful and we resigned ourselves to being childless.  Around 1992, we were in need of individual health insurance.  Due to her pre-existing condition of infertility, the policy we bought excluded further treatments and anything related to childbirth and delivery.  We thought it was a moot point.  Shortly after, we conceived in the old-fashioned way and in 1993 my wife delivered a baby boy in the normal way with no complications.  The hospital bill for this blessed event was over $14,000 -- full retail, all on us.

In 2008, my wife's job was downsized and we again needed to pick up individual coverage.  We applied for a policy with United Health.  My son and I were approved, but my wife was denied.  Her sin this time was a recent diagnosis of high blood pressure -- mild, treatable and under control, but even so, another dreaded pre-existing condition.  (Interestingly, at her just-eliminated job, she was covered under a group plan from the very same United Health which was now rejecting her on an individual basis.)  The only affordable plan we could find turned out to be for catastrophic coverage only, with a super-high deductible.

It was, as Joe Biden put it, a BFD.

When the ACA was signed into law and became available to us, we promptly dumped our crappy old individual policy and signed up for a plan on the federal exchange.  We have no regrets.  For us, Obamacare has addressed the unfairness of pre-existing condition exclusions and the problem of substandard coverage.  Neither practice is permitted under the ACA.  And Obamacare's premium subsidies are critically important to us.  Because we aren't part of an employer-provided group plan, those subsidies have allowed us to have real health coverage at affordable prices.  Don't forget that most people covered by an employer group plan are, in effect, premium-subsidized by their company's contribution to the cost of that plan.

(And remember that Obamacare does not set premiums and has not "caused" premium increases.  Our for-profit system of health care delivery does little to hold down the ever-escalating costs of hospitals, doctors, and drugs.  As a result, health insurance premiums always increase.  State insurance departments play a role with rubber-stamp approvals of rate requests.)

Obamacare has reduced the number of uninsured Americans to its lowest level ever.  Virtually all of those covered by an Obamacare plan are, like us, happy with it.  Covered by it or not, the majority of Americans are opposed to repealing Obamacare.  Many, like us, are in favor of expanding it.  Hospital groups want to keep it.

The only ones who want to get rid of it are those in the gerrymandered echo chamber of the Republican House caucus.  The Speaker's bright idea is an immediate repeal of the ACA, replaced with . . . nothing.  Up-front premium subsidies would be replaced with a year-end tax credit scheme, wherein I first pay the full cost of my individual plan and hope to get some of it back later when I file my return.  Hey, thanks.

Mr. Ryan and Mr. Tiberi, your motives are showing, and spite and retribution do not look attractive on you.  You obviously resent the President's signature accomplishment.  You obviously hate the name "Obamacare."  But your payback mentality will not accomplish anything productive, and will in fact harm tens of millions of people, including me and my family.  Your "repeal" fetish is unnecessary, cruel and just plain WRONG.  The majority of Americans know it.  I urge you, I beg you, to stop what you're planning and work instead to improve and expand the ACA.

If some form of repeal should reach the Senate, I know I can count on Sen. Brown to do the right thing and vote against it.  How about you, Sen. Portman?  During the recent campaign, you frequently mentioned "standing up to my own party" on certain trade issues.  If there would ever be another good time to stand up to your party, a House bill to repeal the ACA would be it.  Can I count on you, Sen. Portman, to vote against repeal?  Please?

Despite the posturing of House Republicans, Obamacare is in fact working.  More people have coverage than ever before, and the rate of increase in health costs is lower than it was before Obamacare.  But like most beneficial government programs, it's not perfect -- it's a complexity of pluses and minuses.  So how can we improve it?

Keep Obamacare as it is and add two things:

1.  Require major insurance carriers to participate in the health exchanges.  As it stands now, citizens are required to have health insurance, but insurance companies can refuse to offer it.  Aetna and United Health recently pulled out of the exchanges because they didn't like the customer mix.  Oh, suck it up, buttercup!  This is what happens when health care is strictly a for-profit proposition.  Both companies are huge and will be fine regardless.  Everybody into the pool -- if I've gotta have it, they've gotta offer it.

2.  Establish a public-option health plan with Medicare-based rates.  Allow this plan to negotiate hospital/doctor reimbursements exactly as Medicare has done for decades.  An affordable, popular public-option plan would drive down costs and force private insurance companies to compete.

In America, we spend more on health care than the next ten highest-spending countries combined.  Those rising costs -- insurance premiums, hospitals, doctors, pharmaceuticals -- are a real concern, just as they were to an even greater degree before Obamacare.  The best way to rein in the costs is to do what all the other advanced countries of the world have already done, and move to a single-payer system, a version of Medicare for all.  Single-payer is the best system to deliver cost-effective health care to the greatest number of people.  The sooner our elected officials embrace that truth, the better off we'll be.

Obamacare is not the problem, our system is.  For-profit, fee-for-service health care has allowed a lot of people to make a lot of money, but the general public has not been well-served by it.  We pay more and get less than anywhere else on earth.  In health care, it's imperative that we move beyond corporate interests and shareholder benefit.  We must act in the public interest for the greater good of all Americans.

Obamacare is an historic first step in doing just that.  It would be an historic mistake and a grievous error in judgment to repeal it.  My family and I are covered by Obamacare.  We need it, we like it, and we want to keep it.

Again, I urge you to preserve Obamacare, strengthen it and expand it.

And that's my Obamacare story.