House Democrats’ Smart Plan To Bolster Obamacare

(Bloomberg Opinion) -- Even before this week brought news of fresh Justice Department efforts to destroy the Affordable Care Act, the health-care law was already in dire need of reinforcement. Congress weakened it more than a year ago by withdrawing the tax penalty for Americans who go without health insurance. And the White House has inflicted a series of further wounds, from making it harder for people to learn about and enroll in Obamacare plans to enabling junk health insurance to be sold in place of good-quality coverage.

The ACA remains under fierce assault. And that is all the more reason to welcome a new effort by Democratic leaders in the House of Representatives to buttress the law.

Assorted blows against Obamacare have caused premiums for individual health-care policies to be set about 16 percent higher than they otherwise would have been this year. Enrollment fell by 300,000 for 2019 — extending a disgraceful pause in what had been, after passage of the ACA, a steady expansion in American health-care security.

Then on Monday the Justice Department told a federal appeals court that it agrees with a district court judge’s stunning ruling: Because Congress has eliminated the individual mandate’s tax penalty, the entire ACA should be struck down. This argument may not survive the appeals process, but it underlines the need to strengthen the law.

The Democrats’ new legislation would fund new efforts to boost Obamacare enrollment, increase the tax subsidies for insurance buyers on the federal and state exchanges, and expand the population eligible for those subsidies. It would create a national reinsurance program to help cover expensive insurance claims, and help states that still rely on the federal insurance marketplace to create exchanges of their own — steps that ought to lower people’s insurance premiums.

The bill would also reverse the administration’s decision to allow “short-term” health insurance to last for as long as three years. Such policies, unlike those regulated by the ACA, fail to cover treatment for pre-existing conditions or provide Obamacare’s 10 essential benefits — including hospitalization, prescription drugs and mental-health treatment. That makes the policies cheaper, but useless or unavailable for many people who need medical care.

The Democrats’ plan would also reverse administration waivers allowing states to sanction insurance that fails to cover pre-existing conditions.

These reforms wouldn’t be cheap. The Congressional Budget Office has yet to weigh in, but the cost could be hundreds of billions of dollars over 10 years. One way to afford it would be to restore the individual mandate tax penalties, which were expected to bring in $314 billion over a decade. Restoring the mandate would at the same time undermine the current legal argument that the ACA is invalid without it.

With this measure, the Democratic leadership isn’t proposing a revolutionary single-payer plan, but more of the incremental progress toward health-care security that’s already been accomplished by the ACA — which, by the way, is now a broadly popular law. As the Trump administration pursues a radical legal attack on Obamacare’s achievements, the new bill shows that the Democrats can lead responsibly on this vital issue.

Editorials are written by the Bloomberg Opinion editorial board.

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