Is Obamacare ‘Failing’ In Texas?

Many Texans have been able to acquire health insurance they otherwise wouldn’t have, via the Affordable Care Act. Republican lawmakers say high premium costs are the reason repeal is needed.

By Ashley LopezJuly 24, 2017 9:30 am, , , ,

From KUT:

For Carol Elliott, a Port Aransas resident in her early 60s, the Affordable Care Act is not a failure.

“The Affordable Care Act saved my life,” the musician says.

Elliott lived in Nashville for a long time, but has spent the last 15 years living in the island town in the Gulf of Mexico off the Texas shore.

She says money has always been tight, and she’s had to cut corners through the years. That’s often meant she’s been priced out of health insurance.

But when the Affordable Care Act, also known as Obamacare, was passed in 2009, things started looking up. That was especially true when an online marketplace allowing people to buy insurance directly from companies with the help of government subsidies was created under the law.

As soon as the exchange was up and running in Texas, Elliott says, she signed up.

“And a week later – maybe it was a couple weeks – I was diagnosed with breast cancer,” she says.

Doctors caught her cancer early, and Elliott was able to avoid chemotherapy. Her treatment plan included a lumpectomy, radiation and CAT scans, which were all covered by her new insurance plan.

“I was able to get all the treatment I needed,” she says. “My out-of-pocket expenses for everything that I just outlined were really minimal.”

Elliott, who is now cancer-free, says she has noticed some changes in her insurance plan lately.

“After the first year, the cost has gone up some,” she says.

Premium Increases

In their fight to repeal Obamacare, Republicans have repeatedly pointed to a steady increase in premiums. But the prescriptions and causes for these premium hikes are different depending on whom you talk to. The Senate is expected to try again next week to vote to repeal Obamacare, which has been a GOP goal for years. President Trump says if Republican efforts to kill the law fall short, his plan is to just let it implode.

“We will let Obamacare fail and then the Democrats are going to come to us and say, ‘How do we fix it?’” he told reporters Tuesday.

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Proponents of the Affordable Care Act argue the existing law needs to be enforced and shored up. Yes, premiums are going up, Elliott says, but she points out that she is still able to afford her health plan.

“The vast majority of enrollees are shielded from those premium increases,” says Stacey Pogue, a senior policy analyst with the left-leaning Center for Public Policy Priorities. “They’re not paying it out of their pockets because we have subsidies that offset the increase for those enrollees. But the underlying premium is going up – and that is important.”

Pogue says in the first few years, the average premium went up about 3 to 5 percent in Texas, which is pretty modest. This past year, though, increases were around 18 percent. While that’s high, Pogue says, it’s actually lower than the national average. And again, she says, Obamacare was designed to protect consumers from shouldering the burden of premium increases.

Those increases are why Republicans, including Sen. John Cornyn, say the law is failing. In fact, he says he thinks it will get worse under the law’s own weight.

“We are projected to see double-digit increases in premiums and insurance companies pulling out of the marketplace unless something is done,” he told reporters during a conference call.

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