This is an archived article that was published on sltrib.com in 2016, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.
Because repeal-and-replace Republicans still have no grasp of what they would be repealing and no clue as to what they might replace it with, the Affordable Care Act is still the means by which millions more Americans, and thousands more Utahns, have that basic component of civilized life, health care coverage.
The percentage of people who have no coverage has fallen significantly since the ACA, also known as Obamacare, was passed in 2010. That is an unalloyed good. Every American who goes without health care coverage is a weak spot in the fiscal and physical well-being of every other American.
The challenge now is to build on what has been done, extend coverage to more people and continue to bend the curve of ever-rising health care costs downward.
The enrollment period for the relatively few people who buy their insurance through the individual exchange market opened Tuesday and runs through Jan. 31, 2017. (For coverage to kick in by Jan. 1, enrollment must be done by Dec. 15.)
Exchange premiums are generally higher than in the past and the number of choices has decreased. But, thanks to federal tax subsidies, most Utahns can still buy policies through healthcare.gov starting at $75 a month.
For the majority who still get their coverage through their employers, the federal government figures that, due in part to the cost-containment features of the ACA, those health plans cost each Utah family some $1,900 less in 2015 compared to what would have happened without Obamacare.
Republicans, from Donald Trump on down, reflexively condemn the ACA as a disaster. Which it clearly is not, at least as measured by the most important metric, the number of people who now have coverage. Nationally, the uninsured rate has fallen to 8.6 percent. That's the lowest ever, though still a disgrace compared to the rest of the civilized world.
The percentage of Utahns without coverage dropped from 15.3 percent in 2010 to 10.3 percent in 2015. Among Utah children, 7.2 percent are uninsured. That's a nice decline, but still shamefully higher than the national rate of 4.8 percent.
Another 75,000 or more people would have been covered were it not for the morally and fiscally reprehensible act of the Utah House blocking both Medicaid expansion and the Healthy Utah alternative put forward by Gov. Gary Herbert.
Making the ACA work as envisioned may require a stiffer penalty assessed to those who don't buy insurance, and so don't support the system they will rely upon if they are sick or injured. Without a base that includes young, healthy people, no insurance plan, government or private, can survive.
The ACA of the future, or its replacement, must keep such key features as ending discrimination against people with pre-existing conditions and allowing people to stay on their parents' policies until they are 26 years old.
Enough people have gained enough benefits from the ACA that to repeal it now and replace it with anything other than the same system with a new name or a system that is even more government-based that Obamacare ever thought of being would be both a political and ethical disaster.
It is well past time for Americans to stop biting the hand that is trying to heal them and make Obamacare work.