Opponents of the Affordable Care Act, or Obamacare, have long been frustrated in their efforts to get it overturned. They’ve failed time and again both in Congress and the courts. But they may be winning the battle through another method altogether.
One insurance company after another nationwide is choosing to quit offering coverage in the ACA marketplaces. For instance, “six major health insurers that sell plans directly to consumers are bowing out or scaling back on the Affordable Care Act marketplace in Arizona,” according to the Arizona Republic. In that state’s largest county, Maricopa, only two marketplace insurers will remain, and Pinal County doesn’t have a single one left for next year. Here in Colorado, Rocky Mountain Health Plans, a major provider, especially in rural areas, is pullling out at the end of 2016. RMHP’s departure will leave some 3,100 people in Montezuma, Dolores, and La Plata counties scrambling to find another option — and it appears there may be just one, Anthem.
Competition through the ACA was supposed to keep prices down. In its absence, prices will likely keep climbing and the entire system may fall apart.
Hurray! say the ACA opponents, apparently secure in their own coverage through Medicare or employers. Get rid of Obamacare and replace it with “something else” (what is never clearly explained).
But not so fast.
It’s possible that the continual “drip, drip, drip” departure of insurers from the ACA marketplaces will have the opposite effect of what opponents desire, instead encouraging the development of public options or a single-payer system.
If the ACA were suddenly to end, as opponents dream, the vast majority of the millions of people nationwide who now obtain their insurance through it would not be able to purchase individual plans on their own, because their incomes are too low, they have major health problems, or both. They would simply fall out of the system and return to getting health care through hospitals’ emergency departments.
Faced with the possible deterioration of the ACA, the folks who now rely on it may start advocating for options such as Amendment 69, a proposal on Colorado’s ballot this November that would tax all citizens to establish a statewide insurance program with no deductibles and no limits on coverage.
The merits and downsides of Amendment 69 need to be thoroughly studied. We hope that even advocates of a single-payer system will carefully consider the fine print; we don’t want to put in place a system that is doomed to fail. It’s tempting to vote our gut instincts either yea or nay, as voters did when they passed the Taxpayers Bill of Rights, TABOR, which has merits but included so many poorly understood provisions that hundreds of local governments have had to “de-Bruce” to opt out of them.
Health care is a critical issue and will continue to be. Amendment 69 offers one answer. It deserves serious study and thorough consideration.