Political Animal


June 12, 2012 8:58 AM No Substitute For ObamaCare

By Ed Kilgore

In terms of the real lives of many people, it’s good news that a few of the improvements enacted in the Patient Protection and Affordable Care Act of 2010 will be maintained by private health insurers no matter what the Supreme Court does later this month. It’s particularly helpful that UnitedHealthcare, Humana and Aetna are promising to continue covering key preventive care measures without copayments.

But the really big reforms just ain’t happening without something very like ACA, as Jonathan Cohn reminds us:

[T]he really big changes in health care are the ones that come in 2014. That’s when the law makes it possible for anybody, at any age, to get insurance regardless of pre-existing conditions. That’s when the law makes it possible for people making up to four times the poverty line, or about $90,000 a year for a family of four, to get subsidies if they buy coverage on their own. That’s when the law makes it possible for anybody making less than 133 percent of the poverty line, or around $30,000 a year for a family of four, to enroll in Medicaid. That’s when the law establishes a minimum set of benefits that all plans must eventually cover.
These changes will mean financial security and access to health care, not just for the 25 to 30 million people slated to get coverage but for many others with inadequate coverage. But these changes will only happen if the law stays in place, because insurers can’t provide them on their own.

Politically, of course, the private insurer actions mean that an invalidation of ACA by the Supreme Court would create less of an immediate shock, less of a backlash, and less pressure on Republicans to tell us what they would do (their plans range from “nada” to “market-based reforms” that would make the status quo ante look like paradise) if they gain control of Congress and the White House this November. We’d drift into 2013 with many Americans really having little or no idea what had been taken away from them, and what sort of health care dystopia they may soon face.

Ed Kilgore is a contributing writer to the Washington Monthly. He is managing editor for The Democratic Strategist and a senior fellow at the Progressive Policy Institute. Find him on Twitter: @ed_kilgore.


  • Peter C on June 12, 2012 9:10 AM:

    Oh, so out of the kindness of their hearts, big insurance companies might temporarily do the right thing (even if the law which forces them to do these things gets struck down), ... or so they say, ... now.

    They *promise*, ... at least until their next merger. Then all bets (and promises, commitments, and labor agreements) are off. Sorry. It's just how the world is these day. Nothing we can do.

  • T2 on June 12, 2012 9:11 AM:

    I've always figured that some day, after the TeaParty and GOP/Conservative Supreme Court have finished stomping on ACA, Americans will think "gee, maybe guaranteed health care was a pretty good idea after all......too bad it didn't last long". And they'll go back to their cat food dinner, having just mailed a huge check to their Doctor. And they'll vote, once again, for the Republicans that put them in the poverty they enjoy so much.

  • c u n d gulag on June 12, 2012 9:12 AM:

    Conservative Health Care Plan:
    The FYIGMGGYO Act of 2013.
    The "F*ck You! I Got Mine, Go Get Your Own."

    And your death is a small price that I have to pay to live in this, THE Greatestest Mostestest Excepionalistic-expialidocious Country In The HISORY OF THE WORLD!!!

  • lou on June 12, 2012 9:22 AM:

    What?? You mean tax credits won't help the poor purchase individual, Health Savings Account policies with $5,000 premiums and $10,000 deductibles?

  • stormskies on June 12, 2012 9:28 AM:

    I would like to remind us all here that there has been a new law being proposed by Congressman McDermott from Washington State that would allow federal money to be used by the States to implement their own single payer health insurance program. This would be identical to what the State of Vermont has done even though Vermont has done it without the federal money. And, yep, Vermont's health care costs are now dropping per citizen.

    And, of course, our cherished corporate media, the gatekeepers of information for so many, has totally ignored this new law being proposed by McDermot.

  • Peter C on June 12, 2012 9:42 AM:

    During the health care debate (preceeding the ACA), a filibuster prevented the discussion of an alternative Single Payer plan. Essentially, Republican Senators refused to stop talking about whether to discuss Single Payer and thereby prevented the Senate from even talking about Single Payer. No! You can't talk about that!

    But, since money is speech, we can't possibly limit campaign contributions. That would trample our essential freedom to influence elections with our personal billion-dollar fortunes.

    Oh, and turn that bullhorn off; it's distracting me from listening to Limbaugh on the radio. And, get out of my park while you're at it.

  • Rick B on June 12, 2012 9:43 AM:

    This is a propaganda move by the insurance companies to take the pressure off the Supreme Court. This way is the Supreme Court does invalidate the ACA the public is not immediately damaged.

    The goal of the insurance companies it to allow the Supreme Court to invalidate ACA because the insurance companies are completely aware that the political climate is such that they will be allowed to run wild ripping off customers for at least half a decade before the political will to get a handle on health insurance reform again.

  • Hedda Peraz on June 12, 2012 9:57 AM:

    Excuse me, but we DO have a plan: It is the liberal trial lawyers that are forcing doctors to have exorbitant malpractice insurance. Our plan will simply have SCOTUS abolish malpractice suits. Costs come down, and what's a few deaths in exchange for a new set of clubs, or a BMW to put them in?
    Besides, most accidents happen in the home. If people were more careful, they wouldn't need a doctor in the first place!
    See how simple it is, when you are a Republican?

    Next up: Fixing the Minimum Wage.

  • emjayay on June 12, 2012 10:54 AM:

    So, profit making insurance companies generously offer to, if they still feel like it, continue policies (free cancer screenings, kids on parent's insurance until 26) if ACA is shot down by our right wing dominated Supreme Court. These are policies that ultimately cost them nothing or maybe more than pay for themselves. Aetna isn't so sure about ending lifetime limits. Nothing about preexisting conditions of course.

    Great. See, we don't need any laws or anything about health insurance after all.

  • RollaMo on June 12, 2012 12:08 PM:

    I thought from day one that tangible benefits were too far down the road. 2014? Might as well be never for most Americans.

  • PTate in MN on June 12, 2012 3:26 PM:

    "with many Americans really having little or no idea what had been taken away from them, and what sort of health care dystopia they may soon face. "

    The health care dystopia is already upon us. If the Supremes gut the individual mandate, all that will happen is that our bad system will get even worse. But who knows what the Supremes will rule? Personally, I'm betting that they will go wide and take advantage of this rare opportunity to demolish the commerce clause justification for social security and medicare. It's why their reactionary masters put them on the court after all.

    If that happens, Americans will have a powerful dose of dystopia and a very good idea of what has been taken away from them.