Are You Ready For Life After Obamacare?
By: Rebekah Kuschmider
Tags: Affordable Care Act, Politics, Obamacare, Supreme Court, Healthcare

POLITICS

Are You Ready For Life After Obamacare?

What Americans should do to protect their insurance access

Photo by Hush Naidoo on Unsplash

On November 20, the Supreme Court will hear arguments about the validity of the Affordable Care Act. The basics of the lawsuit have been hashed over ad nauseum and you can read good analysis from many good scholars on the issue.

What they aren’t telling you is what to do after the law goes down. Americans need to understand what is at stake if the Court overturns the ACA and they need to have a plan for clawing back at least some of the protections it guaranteed us all.

The ACA, or Obamacare, was a once in a generation effort to impose sweeping reforms on the health insurance industry. The reforms, in my opinion, were badly needed. Prior to 2010, “health insurance” was an undefined product. Policies ranged from Cadillac plans that covered everything under the sun to junk plans that took your premium dollars every month but covered almost nothing. There was no standard definition of what insurance must cover, how it was priced, who could buy it, or when a company could rescind a policy.

The unregulated insurance market meant there was nothing preventing a company from refusing to sell a person a policy due to past health issues. There was no law preventing insurers from limiting coverage for one policyholder but offering more expansive coverage to a different policyholder at the same price. Insurers were permitted to cancel a policy for no reason at all. There were yearly caps on coverage, so a patient might “use up” their allowance of care and be responsible for paying bills out of pocket at a certain point. There were lifetime caps too, after which a patient could not ever be insured again.

The Affordable Care Act made order out of the insurance chaos. The law defined insurance, mandated what services it must cover, and insisted that all consumers be permitted to buy insurance. Pricing must be based on product value, not on the health, age, or gender of the person purchasing it. There are no more coverage caps and no insurer can cut off a policy for reasons other than failure to pay.

Was it a perfect solution? No. But if you can find me a set of government-imposed industry regulations that are a perfect solution, I will buy you a bottle of your drink of choice.

Overturning the Affordable Care Act will amount to deregulating the insurance industry. The companies will be free to revert to pre-Obamacare practices that made them very, very profitable. In fact, I can’t imagine why they wouldn’t revert to that.

Unless someone wrote a law. Or 50 laws.

If I were in charge of establishing a bulwark to protect policy-holders, I would turn to my state legislature to protect me from the loss of federal insurance regulations.

Most state legislatures will meet during the first quarter of 2021 and conduct the bulk of their business well before the Supreme Court will announce their findings in June 2021. Rather than letting them wait and see what is going to happen, use this time to launch an advocacy campaign asking state lawmakers to write a bill with state-level protections that mirror the ACA. To address the uncertainty, lawmakers can attach a trigger to it so that it only goes into effect if the Court overturns the federal law.

Does that trigger idea sound familiar? That’s because I stole it from the anti-abortion movement. There are nine states with triggers that will immediately criminalize abortion in the event that the Supreme Court overturns Roe v. Wade. Thanks for the idea, antis!

If I were crafting a state-level law to protect insurance holders I would prioritize five things:

Guaranteed issue: Insurers would be required to sell policies to anyone, regardless age, gender, or pre-existing conditions.

Insurers would be required to sell policies to anyone, regardless age, gender, or pre-existing conditions. No coverage caps or policy rescinding: There should never be a point where an insurance company stops paying for covered services. Nor should an insurance company be allowed to cancel a policy for any reason other than failure to pay premiums.

There should never be a point where an insurance company stops paying for covered services. Nor should an insurance company be allowed to cancel a policy for any reason other than failure to pay premiums. Specific coverage mandates: Obamacare lists exactly what kinds of healthcare must be covered by insurance. I would cut and paste that list into any new insurance reform bill.

Obamacare lists exactly what kinds of healthcare must be covered by insurance. I would cut and paste that list into any new insurance reform bill. Dependent coverage until age 26: Children can stay on their parents’ plans until they are 26 years old. That is one of the most popular provisions of the law (especially in a job market that is so bad for young adults) and there is no reason to take it away.

It is very simple to get the attention of state lawmakers. Even a dozen calls on a single issue will make them sit up and take notice. Rally a bunch of your friends and neighbors to make calls or send letters that say “I am very concerned that I will lose my insurance if the ACA is overturned. I would like you to take steps to protect me and other residents from predatory practices by the health insurance industry.” You can also show up at any candidate forums before the November election and talk about the issue then. Putting grassroots pressure on lawmakers is an effective strategy for getting them to do what you want.

In healthcare, experts emphasize preventative medicine. Advocating for a replacement for Obamacare in advance will be exactly that.