GOP focus on lowering health premiums may undermine plan

Associated Press

WASHINGTON

Republicans trying to repeal and replace former President Barack Obama’s health-care law are grappling with a hard lesson that vexed him: Quality health insurance isn’t cheap, especially if it protects people in poor health, older adults not yet eligible for Medicare, and the poor.

Something has to give.

Now, the GOP’s laser focus on lowering premiums could undermine comprehensive coverage, such as the current guarantees that people with medical problems can get health insurance, or that plans will cover costly conditions such as substance abuse.

Consumers value comprehensive coverage, since no one is beyond the reach of sickness, or immune from the consequences of age.

“Premiums do not tell the whole story,” said Trish Riley, executive director of the National Academy for State Health Policy, a nonpartisan organization that advises states.

With “Obamacare,” Democrats set out to get more people insured, but they also wanted to bolster the underlying coverage. They required insurers to accept those with medical problems, prescribed a broad range of standard benefits, and established baseline financial protections. Previously, for example, people with a history of cancer could be charged a higher premium or be turned down altogether.

That led to 20 million more insured, but also higher premiums for people buying their own policies, along with tax increases and considerable federal regulation.

Republicans trying to roll back the 2010 health-care law have made their case all about premiums, trying to find ways to give states and insurers flexibility to design plans that cost less. About half the people who buy individual health-insurance policies are subsidized under Obama’s health law, but the rest are not, and many have faced stiff premium increases.

The old saying about getting what you pay for still applies.