Trending the Wrong Way

ACAApproval201604

According to this article from Pew Research it certainly looks as though public opinion on the ACA is trending the wrong way:

The public’s views of the Affordable Care Act, which were evenly divided following the Supreme Court’s ruling last summer upholding a key section of the law, are again more negative than positive. Currently, 44% approve of the 2010 health care law, compared with 54% who disapprove of the law.

The fate of the ACA will, obviously enough, be decided by future administrations. If a Democrat, presumably Hillary Clinton, lives in the White House after January 2017, the legislation will continue to be called “Obamacare” and will continue to live on in one form or another. It will still need a major overhaul. Viability of the program can’t be maintained based on wishful thinking alone.

If the next administration is a Republican administration they might repeal the plan but whatever they replace it with will retain a number of the ACA’s features, e.g. community rating, automatic issue, coverage for pre-existing conditions, etc. I guess that’s a form of immortality.

11 comments… add one
  • jan Link

    Obama scheduled the most grueling aspects of this law to be implemented in 2017, when he would be gone from office. Dovetailing into this scenario are current predictions of greater premium/deduction increases, shrinking exchanges and medical options. Perhaps the reasoning behind the noose tightening, following the initial injections of incentives and freebies — doing away with pre-existing conditions, extending time children could stay on a parent’s healthcare policy, unchecked subsidies, medicaid expansion, random sign-up periods etc. — is that it would be far easier to re-introduce the single payer system as a remedy to the pain created by Obamacare.

  • steve Link

    We have had predictions of massive rate increases ever since Obamacare passed. Hasn’t happened, though I guess it could. Will be a shame to see the major efforts being undertaken to improve quality while restraining costs if it is repealed. On the plus side will make my life a lot easier.

    Steve

  • Jan Link

    Some of the efforts to reduce costs is to have deductibles so high that most costs are funded out of pocket by a person. Also hikes in premiums vary around the country. I have experienced about a 10% increase every year. Others, though, have been higher, and some lower. The rumors swirling around increases, however, have been steady, along with companies like United Health Care getting out of Obamacare because of a billion dollar losses in ’15 & ’16.

  • michael reynolds Link

    Jan, you have not seen 10% per year increases in your health insurance costs, good grief. I live in California, too, and over the last four years my coverage has expanded and my costs are pretty darn stable, even after I went back to a Cadillac plan to cover my out-of-state-kid, the one that thanks to Obamacare I can still cover. You know, the policy that thanks to Obamacare can’t be randomly canceled should I prove unprofitable. The policy that covers pre-existing conditions, thanks to Obamacare.

    Perfect example of why these polls are nonsense. People are comparing apples and oranges, some long-lost employer-paid coverage vs. self-pay. Or a policy that could be canceled on a whim, vs. a policy that will actually cover you if you get sick. Or a policy that carefully excluded every illness that might cost money, vs. a policy that actually pays out.

    Those wonderful policies we all had in our nostalgic fantasies? they were bullshit. They were frauds in many, many cases. Why the hell do you think we needed reform to begin with? Because everything was going so well? Even your sad, disintegrating party admits we needed reform, and they agree on all the goodies, they just don’t like having to pay for it. Big surprise from the party that launches trillion dollar wars while cutting taxes.

  • steve Link

    “I have experienced about a 10% increase every year. Others, though, have been higher, and some lower. The rumors swirling around increases, however, have been steady,”

    We actually collect data so you don’t have rely upon rumors or anecdotes. Costs have not bee going up quickly, especially compared with what we had in the past.

    “Some of the efforts to reduce costs is to have deductibles so high that most costs are funded out of pocket by a person.”

    Yes, that is the market response to controlling costs. Every GOP POTUS candidate until the present has advocated for having “skin in the game”. This is how you do that. However, what I am talking about is what we are doing at the clinical level. Cutting out unnecessary surgeries, cutting length of stays while having better outcomes. Controlling pain while minimizing narcotics. Using the lower or lowest cost provider when able. (We use mid-levels a lot.) Standardizing equipment and protocols. That kind of stuff.

    Steve

  • Guarneri Link

    Everything is great. There is standard issue political self aggrandizement, and then there is worrisome delusion.

    http://www.zerohedge.com/news/2016-04-28/obama-admits-couldnt-convince-americans-recovery-bashes-big-short

    Is it any wonder the voters are pissed off?

  • steve Link

    Don’t engineers take math? GDP per capita is what we should be interested IMHO. If you look at that number you find Obama does better than both Bush’s, Nixon and Eisenhower. Still middle of the road and we should do better. The voters should be mad because this has been going on for 15-20 years, at least. They should also be mad because what growth we do get goes mostly to a tiny group of people.

    Steve

  • CStanley Link

    Anecdotal, of course, but our premium and deductible each rose by about 13% in 2016 over 2015. I aims we are among those getting hammered because we are high health care users (family member with a chronic health problem requiring multiple prescriptions each month and several physicians to manage his care.)

    Had a platinum plan in 2015 which Humana discontinued (there are no longer any platinum plans in GA, presumably the commissioner would not allow the rate hikes that the insurers said they needed to cover these plans profitably.) So we stepped down to a gold plan which costs more with fewer benefits.

    As for skin in the game, I suppose I’m guilty of thinking that would be helpful to the system but now that I’m putting in so much skin I fail to see how it helps reduce costs. It’s not as though we have many options as health care consumers.

  • jan Link

    In considering CStanley’s comments, the PPACA has delivered different outcomes for different people. My own increases already stated are what they are. However, most of my doctors don’t take any insurance anymore. So, I’m primarily paying out of pocket. Luckily, though, my medical needs have been acute and not chronic — a broken ankle, torn meniscus, and stasis dermatitis following the ankle break. All of these are workable within our budget. Our son, though, lost his health insurance altogether, as they moved out of state, and he has not been motivated to go into Covered CA to replace it. Ironically, he just received his tax refund, and there was no evidence of a mandate penalty either.

    I know people with varying circumstances relating to the PPACA. Those getting subsidies, or are on some kind of medicaid, are satisfied with the health system as it now stands. However, those who don’t qualify for subsidies, have special needs that aren’t addressed as they once were, are saddled with huge deductibles are not happy at all. According to the above graph they are the majority. But, majorities are not relevant when it comes to this law, as a large majority were “happy” with the plans they once had, before Obamacare was passed, and what good was such a high statistical satisfaction percentage when it came to the dems voting it through?

  • steve Link

    jan- The very large percentage of people unhappy with Obamacare is a political issue. Those people who have Obamacare, including Republicans, like it. (Of course the highest rated plans are always government plans, but Obamacare has been doing pretty well.) This is an older poll but the numbers have not been that much different. Almost everything you complained about has stats collected on it and the numbers are not as bad as you think. Google around or ask and I can point you.

    “When asked what they think of the Affordable Care Act (ACA), colloquially known as ObamaCare, Republicans are scathing and united in their disapproval. According to Gallup, 87 percent of Republicans disapprove of the law, and 77 percent think it will make the healthcare situation worse.

    But in terms of their own experiences with ObamaCare?

    According to a new poll taken by the Commonwealth Fund, people enrolled in ObamaCare are satisfied. And yes, that includes Republicans:

    Overall, 73 percent of people who bought health plans and 87 percent of those who signed up for Medicaid said they were somewhat or very satisfied with their new health insurance. Seventy-four percent of newly insured Republicans liked their plans. Even 77 percent of people who had insurance before — including members of the much-publicized group whose plans got canceled last year — were happy with their new coverage. [Commonwealth Fund]”

  • Andy Link

    I think Steve is right that Obamacare is popular with the people whose opinion matters most – those enrolled in it. Of course it’s still early days and a lot could change. We don’t even know if the exchanges, as they’re currently constructed are viable over the long-term. It’s a great experiment for sure.

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