Now that our area’s top insurer, Blue Cross and Blue Shield of Kansas City, has announced that it is pulling out of the Affordable Care Act exchange next year, about 67,000 of its customers in Kansas and Missouri are vulnerable.
Congressional Republicans insist that they don’t want insurance markets here or anywhere else to fail. But their party has done everything in its power to encourage that outcome.
And since President Donald Trump has said he might just let the exchanges collapse, that has only added to the uncertainty that makes this result more likely.
Our own elected officials seem mainly concerned with making sure it’s Democrats who get the blame if that happens.
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Kansas Gov. Sam Brownback says Blue KC’s exit shows “Obamacare’s death spiral is growing worse,” and his fellow Republican, U.S. Sen. Roy Blunt of Missouri, called it a reminder that President Barack Obama was all wrong when he said that if you liked your doctor, you could keep your doctor.
“It is another devastating blow,” Blunt said, “to families that are already struggling with higher costs and less access to quality health care under the law.”
He is right about that.
But let’s not forget how we got here.
Or lose sight of the fact that most health care costs — for Medicare and in the employer market — have actually risen far less rapidly under Obamacare than they did before the law was passed.
(For instance, employer plan premiums have risen 20 percent since 2011, compared to 31 percent in the previous five years and 63 percent in the five years before that, according to the nonpartisan Kaiser Family Foundation.)
Still, costs have continued to move in the wrong direction, and especially in states like ours that did not expand Medicaid, many insurers have been losing money on the ACA plans.
A safety net for those companies was written into the Obamacare law because it was obvious that initial payouts would be sizable for people who hadn’t had insurance in a long time, if ever, and would almost certainly need more care at first.
Insurers were supposed to be able to make up for those outlays with user fees kicked in by those companies that were making money.
But there weren’t enough of those right away, and only two years after the original bill was signed into law, Republicans blocked the government from funding those payments any other way.
It’s not clear that the GOP-controlled Senate can agree on any health care bill at all, so just kicking what we’ve got until it falls apart isn’t an answer.
Letting Americans without coverage get it under Medicare would be one way to go. A bill introduced last week by Democratic Sen. Claire McCaskill of Missouri that would allow those in counties without ACA insurers to buy into the same DC exchange available to members of Congress is another plausible idea.
If it’s good enough for members of Congress, after all, then why wouldn’t it be good enough for their constituents?