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The Affordable Care Act – One Year Later

Wiki Commons

For this Thanksgiving, last winter’s “polar vortex” became this season’s “bomb cyclone” – meteorologists’ trendy term for an intense, fast-moving storm resulting from the jet stream shifting and sending frigid air roaring south into the United States, icing the roads and causing wind-chills to flirt with zero.

But the cold can’t last forever.

Just as cyclical are cynical political maelstroms, and though Washington Republicans recently won the Senate and a few governorships, it’s somehow difficult to believe that the momentary GOP resurgence will further disrespect President Obama through impeachment, or discount climate change to the peril of the planet, or discard the insured, the poor or immigrants.

Consider theAffordable Care Act (ACA). Another enrollment is open and business magazines and groups have conceded that the law stopped the double-digit increases in health insurance premiums common a decade ago. In 2004, those premiums went up seven times faster than inflation, according to the nonpartisan League of Women Voters.

A study from Price Waterhouse Coopers projects median premium increases for next year to be about 6 percent, a finding echoed in Bloomberg News, where Alex Wayne added, “While foes of the Affordable Care Act warned of double-digit rate increases, the costs of premiums seen so far is more modest.”

Forbes magazine’s Rick Ungar wrote about a report from the McKinsey Center for U.S. Health System Reform, which, Ungar said, “expects that a number of people purchasing higher price plans … will move to either the lowest or second lowest plan. For those people, the study suggests the mean increase will be less than 2 percent.”

Meanwhile, the number of insurers increased by 26 percent in the last year, and the number of products grew 66 percent, Ungar said, adding, “It is going to be quite a stretch for Obamacare opponents to turn this data into bad news.”

Bill Knight

OK, good news hasn’t stopped Obama-bashers. After all, as Lee Papa writes in The Rude Pundit blog, “Things seem to be progressing. Millions of people have health insurance who didn't have it before. The unemployment rate is below 6 percent, down from 10 percent in 2009. The deficit has shrunk to just 3 percent of GDP, down from 9.8 percent in 2009. Corporate profits are up. Oil imports are down. Alternative energy sources are finally growing. The crime rate is at a 20-year low – so low that Obama wants to try to roll back some of the ludicrous sentencing laws from the Clinton era. And how many states are we up to on same-sex marriage? And how many terrorist attacks in the United States since Obama's inauguration?”

Of course, dumb comments by the arrogant Obamacare aide Jonathan Gruber, an MIT professor who’s intellectually tone deaf – have presented an opportunity to criticize Obama, health care reform and an allegedly deceptive aspect of the law. So it’s no shock that an unexpected challenge to the ACA is now set to be heard by the U.S. Supreme Court in March for a June ruling. “King v. Burwell” disputes the federal government’s power to distribute tax credits to low- and middle-income people to aid the purchase of private insurance.

Four words in one sentence of a law of hundreds of pages does make millions of Americans eligible for federal subsidies to get insurance; abolishing that could mean between 4 million and 7 million people in dozens of states without health-insurance exchanges would be left without the means to buy insurance.

Most federal judges tossed out the suit, but the conservative-leaning Supreme Court accepted the appeal.

Analysis by the RAND Corp. shows concern with the court threat. RAND’s Christine Eibner wrote, “If subsidies are eliminated entirely, our research predicts substantial disruption in the individual health insurance market. Many people could not afford to enroll.”

In other words, fewer subsidies would mean more people dropping policies, which could force insurers to raise prices, which could cause others to drop coverage, et cetera, et cetera, et cetera.

A 5-4 decision killing this one ACA provision would be terrible for consumers, hospitals and insurers – plus for the GOP, which purports to represent many people who are benefiting, like in Mitch McConnell’s Kentucky. In fact, the Kaiser Family Foundation has shown that the states hardest hit would be in the Republican-red South.

So we must stay aware, work to genuinely improve the Affordable Care Act, and think of Spring.  

Contact Bill at; his twice-weekly columns are archived at

The opinions expressed are not necessarily those of Tri States Public Radio or Western Illinois University.